Presence of serum antinuclear antibodies correlating unfavorable overall survival in patients with chronic lymphocytic leukemia.

Qian Sun; Li Wang; Hua-yuan Zhu; Yi Miao; Wei WU; Jin-hua Liang; Lei Cao; Yi Xia; Jia-zhu WU; Yan Wang; Rong Wang; Lei Fan; Wei XU; Jian-yong LI

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Presence of serum antinuclear antibodies correlating unfavorable overall survival in patients with chronic lymphocytic leukemia.

Author: Qian SUN ¹ ; Li WANG ¹ ; Hua-Yuan ZHU ¹ ; Yi MIAO ¹ ; Wei WU ¹ ; Jin-Hua LIANG ¹ ; Lei CAO ¹ ; Yi XIA ¹ ; Jia-Zhu WU ¹ ; Yan WANG ¹ ; Rong WANG ¹ ; Lei FAN ¹ ; Wei XU ¹ ; Jian-Yong LI ¹
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1. Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, China.
Publication Type:Journal Article
MeSH: ADP-ribosyl Cyclase 1; blood; Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Antinuclear; blood; Autoimmunity; physiology; Female; Humans; Kaplan-Meier Estimate; Leukemia, Lymphocytic, Chronic, B-Cell; blood; mortality; Male; Middle Aged; Multivariate Analysis; Mutation; genetics; Proportional Hazards Models; Retrospective Studies; Survival Analysis; Tumor Suppressor Protein p53; blood; Young Adult; ZAP-70 Protein-Tyrosine Kinase; blood
From: Chinese Medical Journal 2019;132(5):525-533
CountryChina
Language:English
Abstract: BACKGROUND:Serum antinuclear antibodies (ANAs) are positive in some patients with chronic lymphocytic leukemia (CLL), but the prognostic value of ANAs remains unknown. The aim of this study was to evaluate the role of ANAs as a prognostic factor in CLL.
METHODS:This study retrospectively analyzed clinical data from 216 newly diagnosed CLL subjects with ANAs test from 2007 to 2017. Multivariate Cox regression analyses were used to screen the independent prognostic factors related to time to first treatment (TTFT), progression free survival (PFS) and overall survival (OS). Receiver operator characteristic curves and area under the curve (AUC) were utilized to assess the predictive accuracy of ANAs together with other independent factors for OS.
RESULTS:The incidence of ANAs abnormality at diagnosis was 13.9%. ANAs positivity and TP53 disruption were independent prognostic indicators for OS. The AUC of positive ANAs together with TP53 disruption was 0.766 (95% confidence interval [CI]: 0.697-0.826), which was significantly larger than that of either TP53 disruption (AUC: 0.706, 95% CI: 0.634-0.772, P = 0.034) or positive ANAs (AUC: 0.595, 95% CI: 0.520-0.668, P < 0.001) in OS prediction. Besides, serum positive ANAs as one additional parameter to CLL-international prognostic index (IPI) obtained superior AUCs in predicting CLL OS than CLL-IPI alone.
CONCLUSION:This study identified ANAs as an independent prognostic factor for CLL, and further investigations are needed to validate this finding.