Thymic function and immunoglobulin mutation genotype in B-cell chronic lymphocytic leukemia patients

Authors

  • Elena Nardini,

    1. Department of Experimental Oncology, Molecular Targeting Unit, National Cancer Institute, Milan, Italy
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    • The first two authors contributed equally to this work.

  • Francesca Neri,

    1. AIDS Immunopathogenesis Unit, Department of Immunology and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
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    • The first two authors contributed equally to this work.

  • Elisa Vicenzi,

    1. AIDS Immunopathogenesis Unit, Department of Immunology and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
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  • Guido Poli,

    1. AIDS Immunopathogenesis Unit, Department of Immunology and Infectious Diseases, San Raffaele Scientific Institute, Milan, Italy
    2. School of Medicine, Vita Salute San Raffaele University, Milan, Italy
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  • Daniela Capello,

    1. Hematology Unit, Department of Medical Sciences, and IRCAD, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
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  • Gianluca Gaidano,

    1. Hematology Unit, Department of Medical Sciences, and IRCAD, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy
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  • Umberto Vitolo,

    1. Division of Hematology, A. O. San Giovanni Battista della Citta' di Torino, Torino, Italy
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  • Sylvie Ménard,

    Corresponding author
    1. Department of Experimental Oncology, Molecular Targeting Unit, National Cancer Institute, Milan, Italy
    • Department of Experimental Oncology, Molecular Targeting Unit, National Cancer Institute, Via Venezian 1, 20133 Milan, Italy
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    • Fax: +39-02-23903073

  • Andrea Balsari

    1. Department of Experimental Oncology, Molecular Targeting Unit, National Cancer Institute, Milan, Italy
    2. Institute of Pathology, University of Milan, Italy
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Abstract

B-cell chronic lymphocytic leukemia (B-CLL) is characterized by a profound dysregulation of the host's immune system at both the humoral and cellular level. We investigated to see if this dysregulation could be due partly to thymus dysfunction by quantifying the number of signal joint T-cell receptor excision circles (sjTRECs) in peripheral blood mononuclear cells of 30 untreated B-CLL patients at diagnosis and in age-matched healthy controls. sjTRECs were found decreased, normal and elevated in 19, 9 and 2 patients, respectively, in comparison to age-matched controls. We next speculated that sjTREC levels might be related to an accredited B-CLL prognostic marker represented by the somatic hypermutation (SHM) status of the variable heavy chain (VH) genes. Eight of 17 patients with SHMs had sjTREC levels in the range of or higher than normal donors, whereas only 3 of the 13 patients lacking SHMs had normal sjTREC levels. After a 5-year observation period in 16 patients for whom a clinical follow-up was available, only 2 of 10 patients with SHMs progressed vs. 5 of 6 patients without SHMs and 3 of 7 patients with normal or higher sjTREC levels progressed vs. 4 of 9 with low sjTREC levels. Our study demonstrates that sjTREC levels are decreased in >60% of B-CLL patients and suggests a potential role of thymus in the immune dysfunction of these patients. © 2003 Wiley-Liss, Inc.

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