B-cell receptor configuration and adverse cytogenetics are associated with autoimmune hemolytic anemia in chronic lymphocytic leukemia

Luca Laurenti, Francesco Maura, Carlo Visco, Erika Falisi, Gianluigi Reda, Sonia Fabris, Luca Agnelli, Giacomo Tuana, Marta Lionetti, Nicola Guercini, Elisabetta Novella, Ilaria Nichele, Anna Montaldi, Anna Gregorini, Wilma Barcellini, Vincenzo Callea, Francesca R. Mauro, Robin Foà, Antonino Neri, Francesco RodeghieroAgostino Cortelezzi

Risultato della ricerca: Contributo in rivistaArticolo in rivista

25 Citazioni (Scopus)

Abstract

The development of autoimmune hemolytic anemia (AIHA) in patients with chronic lymphocytic leukemia (CLL) is associated with specific biological features. The occurrence of AIHA was hereby investigated in a retrospective series of 585 CLL patients with available immunoglobulin heavy chain variable (IGHV) gene status. AIHA occurred in 73 patients and was significantly associated with an IGHV unmutated (UM) status (P < 0.0001) and unfavorable [del(17)(p13) and del(11)(q23)] cytogenetic lesions (P < 0.0001). Stereotyped HCDR3 sequences were identified in 29.6% of cases and were similarly represented among patients developing or not AIHA; notably, subset #3 was associated with a significantly higher risk of AIHA than the other patients (P = 0.004). Multivariate analysis showed that UM IGHV, del(17)(p13) and del(11)(q23), but not stereotyped subset #3, were the strongest independent variables associated with AIHA. Based on these findings, we generated a biological risk score for AIHA development according to the presence of none (low risk), one (intermediated risk), or two (high risk) of the independent risk factors. Overall, our data indicate that UM IGHV status and/or unfavorable cytogenetic lesions are associated with the risk of developing secondary AIHA in CLL patients and suggest a possible role of specific stereotyped B-cell receptor subsets in a proportion of cases.
Lingua originaleEnglish
pagine (da-a)32-36
Numero di pagine5
RivistaAmerican Journal of Hematology
Volume88
DOI
Stato di pubblicazionePubblicato - 2013

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Anemia, Hemolytic, Autoimmune
  • Chromosome Deletion
  • Chromosomes, Human, Pair 11
  • Chromosomes, Human, Pair 17
  • Female
  • Follow-Up Studies
  • Humans
  • Immunoglobulin Heavy Chains
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Male
  • Middle Aged
  • Receptors, Antigen, B-Cell
  • Retrospective Studies
  • Risk Factors

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