Old DAT and new data: positive direct antiglobulin test identifies a subgroup with poor outcome among chronic lymphocytic leukemia stage A patients.
Fiche publication
Date publication
janvier 2015
Journal
American journal of hematology
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DELMER Alain
Tous les auteurs :
Quinquenel A, Al Nawakil C, Baran-Marszak F, Eclache V, Letestu R, Khalloufi M, Boubaya M, Le Roy C, Varin-Blank N, Delmer A, Levy V, Ajchenbaum-Cymbalista F
Lien Pubmed
Résumé
Only a minority of chronic lymphocytic leukemia (CLL) patients harboring a positive direct antiglobulin test (DAT) will develop autoimmune hemolytic anemia (AIHA). In a single institution cohort of 378 CLL patients, 56 patients (14.8%) had at least one positive DAT during the course of the disease, either at diagnosis or later. We found no relationship between the time of the first positive DAT and overall survival (OS). However, patients with a positive DAT who did not develop AIHA had the same adverse outcome as patients who developed AIHA. Of the patients who were in Binet stage A at diagnosis, those with a positive DAT had a significantly shorter OS, regardless of their IGHV mutational status, however, there was a strong association with VH1-69. By multivariate analysis, a positive DAT was found to be an independent adverse prognostic factor for OS. Thus, DAT represents a strong adverse prognostic factor and its determination should be repeated during follow-up.
Mots clés
Adult, Aged, Aged, 80 and over, Anemia, Hemolytic, Autoimmune, diagnosis, Cohort Studies, Complement C3d, analysis, Coombs Test, Data Interpretation, Statistical, Disease Progression, Disease-Free Survival, Female, Follow-Up Studies, Humans, Immunoglobulin G, blood, Kaplan-Meier Estimate, Leukemia, Lymphocytic, Chronic, B-Cell, complications, Male, Middle Aged, Predictive Value of Tests, Prognosis
Référence
Am. J. Hematol.. 2015 Jan;90(1):E5-8