Klinikinės savybės ir IGHV mutacijos statuso prognostinė reikšmė sergant lėtine limfocitine leukemija (LLL).
Feil, Marina Jutta |
Recenzentas / Reviewer |
Šis magistrinis darbas nagrinėja lėtinės limfocitinės leukemijos (LLL) klinikines ypatybes ir imunoglobulino sunkiosios grandinės kintamosios srities (IGHV) mutacijos statuso prognostinę reikšmę. Tyrime analizuojama, kaip IGHV mutacijos statusas susijęs su pacientų klinikinėmis charakteristikomis, gydymo strategijomis bei ligos progresavimu. Taip pat vertinama šio molekulinio žymens svarba prognozuojant laiką iki pirmojo gydymo ir individualizuojant pacientų gydymą.
Clinical characteristics and prognostic implications of IGHV mutation status in chronic lymphocytic leukaemia (CLL).
This study aimed to investigate the relationship between Immunoglobulin heavy-chain variable region (IGHV) mutation status and clinical characteristics, treatment strategies and prognostic implications in patients with chronic lymphocytic leukaemia. The objectives were to determine the distribution of IGHV mutation status, compare demographic, clinical, laboratory and genetic characteristics according to IGHV status, analyse treatment strategies, evaluate treatment response and assess prognostic significance using time to first treatment (TTFT).
A retrospective analysis of 92 patients diagnosed with CLL at Kaunas Clinics was performed. Statistical analysis included descriptive statistics, independent t-test, Mann-Whitney U test, Chi-square and Fisher’s exact tests, as well as Kaplan-Meier survival analysis with log-rank test.
The results showed a nearly balanced distribution of IGHV mutation status (52.2% mutated, 47.8% unmutated). No statistically significant differences were found between groups in demographic, clinical, laboratory or genetic characteristics (p > 0.05). Patients with mutated IGHV were more often managed with a watch-and-wait strategy. Among treated patients, no significant association between IGHV status and treatment type was observed (p = 0.632). Treatment response analysis demonstrated a higher proportion of regression in the mutated group. However, this difference was not statistically significant (p = 0.276). Kaplan-Meier survival analysis showed a significantly longer TTFT in patients with mutated IGHV (p = 0.04). Mutated IGHV indicated a better prognostic sign due to a longer time without active treatment needs.
In conclusion, IGHV mutation status is an important prognostic molecular marker in CLL and is significantly associated with time to first treatment, but not with baseline characteristics, treatment selection or short-term treatment response in this research.
It is recommended that IGHV mutation status should be routinely measured in all patients diagnosed with CLL. It should be considered in risk stratification and clinical decision-making. Treatment strategies should be based on a comprehensive evaluation of clinical and molecular factors.