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  Česky / Czech version Čas. Lék. čes., 2006, 145, pp. 855–858.
 
Molecular Genetic Characterization of Chronic Lymphocytic Leukemia Aggressivity in Czech Patients: A Nucleotide Variability of Genes Coding for Heavy Chain of Immunoglobulin 
1Kuhrová V., 1Francová H., 1Klimešová D. , 2Brychtová Y., 2Doubek M., 1Trbušek M., 3Brejcha M., 1Dvořáková D., 1,2Mayer J. 

1Centrum molekulární biologie a genové terapie FN, Brno 2Interní hematoonkologická klinika FN, Brno 3PaR LAB s.r.o., onkohematologická ambulance, Nový Jičín
 


Summary:

       Background. Chronic lymphocytic leukemia is a heterogeneous disease manifesting with a variable clinical course. It is evident from many studies, that the division into two main prognostic categories is possible on the basis of mutation status of the immunoglobulin heavy-chain gene. The objective of our work was to identify a presence or absence of IgVH gene mutations in B-CLL patients which are monitored or treated on hematological clinics and to determine the presence of individual D and JH subgenes in malignant population of B-cells. Methods and Results. A nucleotide sequence of IgVH gene of neoplastic cells was analyzed by appropriate molecular-genetic methods. RNA/cDNA was collected from 358 patients and a spectrum of individual subgenes translocations was identified. Our results show that 56.3% of patients manifested an unmutated variable (VH) segment. It is expected from the published data that this group of patients will suffer from aggressive course of the disease and will exhibit a substantially shorter survival in comparison to patients possessing somatic hypermutations. An expanded population of leukemic B-cells showed increased occurrence of clones whose variable segments belong to three different families. VH3 alleles are the ones most frequently used. A frequency of unmutated alleles is prominently shifted into families with VH1 homology. The preferred „diversity and joining“ segments are D3, D2 and JH 4 and JH 6. Conclusions. The analysis of heavy chain immunoglobulin gene after recombinant VH-D-JH segments translocation belongs to a standard hematooncological investigation. The results are an important prognostic criterion for prediction of expected disease aggressivity and for a minimal residual disease monitoring.

        Key words: chronic lymphocytic leukemia, immunoglobulin heavy-chain gene (IgVH), mutation status, somatic hypermutation, prognostic factor.
       

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