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首页> 外文期刊>European Journal of Haematology >Clonal evolution in CLL patients as detected by FISH versus chromosome banding analysis, and its clinical significance
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Clonal evolution in CLL patients as detected by FISH versus chromosome banding analysis, and its clinical significance

机译：FISH与染色体条带分析在CLL患者中的克隆进化及其临床意义

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摘要

The acquisition of new aberrations during the course of chronic lymphocytic leukemia (CLL) named clonal evolution (CE) is usually detected by one of the two methods: chromosome banding analysis (CBA) and interphase fluorescence in situ hybridization (I-FISH). The purpose of this study was to compare the usefulness of FISH and CBA for detecting CE and to evaluate its influence on clinical outcome. FISH and CBA were performed at two time points: baseline and follow-up. Thirty-eight previously untreated patients with CLL were included in this study. CBA and I-FISH revealed CE in 15 (39.5%) and 10 (26.3%) patients, respectively. High-risk CE was detected in six cases by CBA and in five cases by I-FISH. In four cases with CE-dependent 17p abnormalities detected by CBA, metaphase FISH was needed for the confirmation of 17p13.1 deletion. Time from first-line to second-line treatment (TTST) and overall survival (OS) did not differ between patients with and without CE, irrespective of the CE-detecting method used. However, shorter OS (P = 0.043) and TTST (P = 0.006) were observed for the patients with potentially relevant CE (rCE) detected by CBA, in which acquired aberrations were present in at least 20% of undivided cells and/or changed baseline karyotype to abnormal or complex and were not resulting from 13q deletion. Our results suggest that some, but not all, CE-dependent aberrations detected by CBA influence clinical outcome. Moreover, I-FISH, which was aimed at detecting aberrations of prognostic significance, was found to be more precise than CBA in their detection, especially TP53 deletion.
机译：通常通过以下两种方法之一来检测在慢性淋巴细胞性白血病（CLL）过程中称为克隆进化（CE）的新畸变的获得：染色体条带分析（CBA）和相间荧光原位杂交（I-FISH）。这项研究的目的是比较FISH和CBA在检测CE方面的有用性，并评估其对临床结果的影响。在两个时间点进行FISH和CBA：基线和随访。这项研究包括38例先前未经治疗的CLL患者。 CBA和I-FISH分别显示15例（39.5％）和10例（26.3％）患者的CE。 CBA检测出6例，I-FISH检测出5例，发现高危CE。在四例通过CBA检测到CE依赖性17p异常的病例中，需要中期FISH来确认17p13.1缺失。不论是否使用CE检测方法，有或没有CE的患者从一线治疗到二线治疗的时间（TTST）和总生存期（OS）都没有差异。然而，通过CBA检测到具有潜在相关CE（rCE）的患者观察到较短的OS（P = 0.043）和TTST（P = 0.006），其中获得性畸变存在于至少20％的未分裂细胞中和/或已改变基线核型为异常或复杂，并非由13q缺失引起。我们的结果表明，由CBA检测到的部分但不是全部CE依赖性畸变会影响临床结局。此外，发现旨在检测预后意义异常的I-FISH在检测方面，尤其是TP53缺失方面比CBA更精确。

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