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Method of Diagnosis/Prognosis of Human Chronic Lymphocytic Leukemia Comprising the Profiling of Lpl/Adam Genes

a technology of human chronic lymphocytic leukemia and lpl/adam gene, which is applied in the direction of microbiological testing/measurement, biochemistry apparatus and processes, etc., can solve the problems of inaccessibility to most medical facilities, high cost of analysis, time-consuming, etc., and achieve accurate estimation of the prognosis

Inactive Publication Date: 2008-10-23
INST PASTEUR +2
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Benefits of technology

[0012]Further, the above object may be performed using a sample containing previously extracted mRNA (e.g., a mRNA bank), thereby obviating the need to obtain a cellular sample and, thus, an object of the present invention includes a method of identifying a subject with a significant probability of having chronic lymphocytic leukemia in a subject in need thereof by determining the gene expression levels of LPL and ADAM29 in a sample containing mRNA and designating the subject as having a significant probability of having chronic lymphocytic leukemia when expression of at least one of LPL and ADAM29 is detected in said sample.
[0017]The present invention provides a method of allowing accurate estimation of the prognosis in a patient having chronic lymphocytic leukemia, by designating the subject as having a significant probability of having an aggressive form of the disease if there is overexpression of the LPL gene or an indolent form of the disease if there is overexpression of ADAM29 gene.

Problems solved by technology

However, the disease in half of these patients will progress and both staging systems fail to initially identify such patients.
This analysis remains costly, time-consuming and inaccessible for most medical facilities.

Method used

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  • Method of Diagnosis/Prognosis of Human Chronic Lymphocytic Leukemia Comprising the Profiling of Lpl/Adam Genes
  • Method of Diagnosis/Prognosis of Human Chronic Lymphocytic Leukemia Comprising the Profiling of Lpl/Adam Genes
  • Method of Diagnosis/Prognosis of Human Chronic Lymphocytic Leukemia Comprising the Profiling of Lpl/Adam Genes

Examples

Experimental program
Comparison scheme
Effect test

example 1

Patients' Characteristics

[0160]Table 2 summarizes the 127 patients' characteristics:

TABLE 2Clinical and biological characteristics of patientsStagesStagesStage AStage BStage CB + CA + B + CNo. Patients87291140127Age, years*63.058.059.058.561.0Male sex51 (59%)24 (83%) 5 (45%)29 (72%)80 (63%)Lymphocyte count, × 109 / L*15.237.2151.845.019.0Hemoglobin, g / dL*14.113.47.213.013.8Platelets, × 109 / L*212.5160.0187.5172.0198.0Lymphocyte doubling time>12 months64 (84%)NANANANA12 (16%)NANANANAIgVH genesUM27 (31%)17 (59%) 9 (82%)26 (65%)53 (42%)MT60 (69%)12 (41%) 2 (18%)14 (35%)74 (58%)ZAP-7045 (65%) 7 (30%) 3 (33%)10 (31%)55 (54%)≧20%24 (35%)16 (70%) 6 (67%)22 (69%)46 (46%)L / A ratio56 (69%)13 (46%) 2 (20%)15 (39%)71 (60%)≧125 (31%)15 (54%) 8 (80%)23 (61%)48 (40%)Progression22 (25%)NANANANACLL-related death4 (5%)11 (38%) 6 (55%)16 (40%)20 (18%)*Median valuesUM indicates unmutated;MT, mutated;L / A, LPL / ADAM29;NA, not applicable.

[0161]Fifty three patients (42%) were allocated to the UM IgVH group whi...

example 2

LPL and ADAM29 are Better Surrogate Markers for IgVH Mutational Status than SPG20 and NRIP1

[0162]LPL, SPG20, ADAM29 and NRIP1 were first evaluated in an initial series of 71 patients. The present inventors quantified the expression of these 4 genes on total lymphocytes, since preliminary experiments in five patients showed similar results as compared to purified leukemic cells (data not shown). For each gene, the present inventors determined which expression levels could best segregate UM from MT patients using Youden's and validity indexes. Results showed that overall LPL and ADAM29 performed better than SPG20 and NRIP1 to predict UM and MT IgVH profiles respectively (Table 3). The concordance rate was 83% for ADAM29, 77% for LPL, 65% for SPG20 and 45% for NRIP1.

TABLE 3Correlation of gene expression with IgVH mutational statusLPL / GeneLPLADAM29SPG20NRIP1ADAM29expression‡≧1≧3≧3.5≧4≧1UM (n = 37)30782921131716325MT (n = 34)9252867271915331Sensitivity*81%82%57%56%86%Specificity*74%78%79...

example 3

Reproducibility of LPL and ADAM29 Quantification

[0164]Since LPL and ADAM29 appeared to better reflect the IgVH mutational status, the present inventors evaluated the reproducibility of their quantification by RQ-PCR. This was done by comparing results obtained from replicate samples for 4 patients, 2 overexpressing LPL and 2 overexpressing ADAM29. For each patient, 4 replicates were analyzed during the same reaction run (intra-run variability), and this was repeated on 3 different days (inter-run variability). The overall variability of these 12 replicates is shown in Table 4. Of note, intra-run variability was always smaller than overall variability, with CV being less than 0.5% for LPL and less than 1.1% for ADAM29 (data not shown).

TABLE 4Reproducibility of RQ-PCRLPLADAM29PatientCt ± SDCV (%)Ct ± SDCV (%)CLL-7323.54 ± 0.461.97NANACLL-10523.96 ± 0.381.59NANACLL-67NANA27.33 ± 1.184.31CLL-101NANA23.322.21Ct indicates threshold cycle;SD, standard deviation;CV, coefficient of variation...

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Abstract

The present invention provides methods of diagnosis and prognosis of human chronic lymphocytic leukemia (CLL) in a patient in need thereof and methods to determine IgVH mutational status. The methods of the present invention involve measuring the expression profile of two known genes: LPL and ADAM29; and comparing the ratio of their expression to diagnose the presence of CLL or to prognose the likelihood of developing CLL or the symptoms consistent with CLL.

Description

BACKGROUND OF THE INVENTION[0001]1. Field of the Invention[0002]The present invention provides methods of diagnosis and prognosis of human chronic lymphocytic leukemia (CLL) in a patient in need thereof. The methods of the present invention involve measuring the expression profile of two known genes: LPL and ADAM29; and determining the ratio of their expression to diagnose the presence of CLL or to prognose the likelihood of developing CLL, an aggressive or a stable form of the disease or the symptoms consistent with CLL.[0003]2. Discussion of the Background[0004]Chronic lymphocytic leukemia (CLL) displays a variable outcome. The classical Rai1 or Binet2 staging systems have allocated CLL cases into three major risk groups (low [stage 0 in Rai's and stage A in Binet's classification system], intermediate [stages I and II in Rai's and stage B in Binet's classification system], and high [stage III and IV in Rai's and stage C in Binet's classification system]), according to tumor burde...

Claims

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Application Information

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Patent Type & Authority Applications(United States)
IPC IPC(8): C12Q1/68
CPCC12Q1/6886C12Q2600/118C12Q2600/16
Inventor DAVI, FREDERICDIGHIERO, GUILLAUMEDUMAS, GERARDOPPEZO, PABLOSETTEGRANA, CATHERINEVASCONCELOS PINHEIRO, YURI
Owner INST PASTEUR
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