Researchers Discover Predictors for Chronic Lymphocytic Leukemia

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Chronic Lymphocytic Leukemia

Mayo Clinic researchers have identified two key markers that may aid in the quest for earlier diagnosis of chronic lymphocytic leukemia (CLL). The findings can be found in the Journal of Clinical Oncology, Vol. 24, No. 6.

The investigators discovered that serum B-lymphocyte stimulator (BLyS) levels are elevated in patients with B-cell chronic lymphocytic leukemia (B-CLL) who have a family history of lymphoproliferative disorders. In these same patients, they also found a single nucleotide polymorphism (SNP) in the BLyS promoter, a region of the gene that regulates its expression.

"Our data indicate that people who have a familial history of B-cell malignancies are more likely to have elevated BLyS levels and the BLyS SNP compared to healthy individuals," says Anne Novak, Ph.D., Mayo Clinic hematology researcher. "We believe that identification of individuals with elevated BLyS levels or the BLyS SNP may allow for identification of individuals who are predisposed to development of B-cell malignancies - and the findings encourage us in our search for early diagnosis tools." The SNP (a genetic variation in the DNA) identified by the group was found in a region of the BLyS gene that may be responsible for regulation of its expression. BLyS is a protein that influences the growth and survival of B-cells and plays an important role in antibody production.

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More than 92,000 people will be diagnosed in 2006 with lymphoma and other B-cell lymphoproliferative cancers, according to the American Cancer Society. Over 30 percent of them will die from the disease. This study's findings increase the ability to individualize medicine - establishing a more precise risk profile and improving the physician's ability for early diagnosis.

Researchers have long known that early diagnosis makes most cancer treatment more effective, and Dr. Novak and her fellow investigators continue to study ways to pinpoint individual risk and develop affordable and efficient screening tests. "We hope these findings will lead to the first effective screening tool for chronic lymphocytic leukemia," she says. "It is the next step to earlier and better treatment, prevention and hopefully someday a cure."

The study group included 70 untreated patients diagnosed with B-CLL. Twenty-four had familial chronic lymphocytic leukemia, with first- or second-degree relatives diagnosed with a B-cell lymphoproliferative malignancy including B-CLL, non-Hodgkin's lymphoma, multiple myeloma or Hodgkin's lymphoma. The control group consisted of serum samples from 41 age- and sex-matched patients with no personal or family history of a B-cell malignancy.

The average BLyS level in the normal controls was 6.68 nanograms per milliliter (ng/mL), and in CLL patients it was 11.93 ng/mL. Elevated levels were considered to be those greater than 20 ng/mL, and were found in two (5 percent) of the control patients and 13 (19 percent) of the

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