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Clinicoprognostic implications of increased serum levels of vascular endothelial growth factor and basic fibroblastic growth factor in early B-cell chronic lymphocytic leukaemia.

Molica S, Vitelli G, Levato D, Ricciotti A, Digiesi G - Br. J. Cancer (2002)

Bottom Line: When dealing with basic fibroblast growth factor only a correlation with Rai sub-stages (P=0.02) could be found.Patients with both markers below the median experienced the best clinical outcome (median progression-free survival not reached at 40 months).In conclusion, serum levels of either vascular endothelial growth factor or basic fibroblast growth factor are high in patients with early chronic lymphocytic leukaemia, however, only vascular endothelial growth factor predicts behaviour of disease and helps to refine the prognosis of stage A patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy. smolica@libero.it

ABSTRACT
To assess the relative merit of increased serum levels of vascular endothelial growth factor and basic fibroblastic growth factor in predicting the risk of disease progression of patients with early B-cell chronic lymphocytic leukaemia we analyzed 81 Binet stage A patients whose sera were taken at the time of diagnosis and evaluated for the presence of vascular endothelial growth factor and basic fibroblast growth factor using an enzyme-linked immunosorbent assay. Serum levels of vascular endothelial growth factor positively correlated with Rai sub-stages (P=0.03), peripheral blood lymphocytosis (P=0.03), bone marrow histology (P=0.04) and beta2-microglobulin (beta2-m) (P=0.006). When dealing with basic fibroblast growth factor only a correlation with Rai sub-stages (P=0.02) could be found. Different cut-offs set on the basis of a stratification in quartiles, failed to demonstrate any correlation between serum levels of basic fibroblast growth factor and disease progression. In contrast, patients with increased serum levels of vascular endothelial growth factor (above median value, 203 pg ml(-1)) had a three times increased risk of disease progression, although, in multivariate analysis only Rai sub-stages (P=0.0001) and lymphocyte doubling time (P=0.002) retained their prognostic significance. Low levels of vascular endothelial growth factor were indicative of good clinical outcome in the subgroup of patients with either low (P=0.02) or high (P=0.03) beta2-m concentration. Finally, the highest prognostic power was obtained when serum vascular endothelial growth factor and beta2-m were examined in combination. Median of progression-free survival of patients who had both serum vascular endothelial growth factor and beta2-m higher than median value was only 13 months, in contrast median progression-free survival of patients with one marker increased (i.e. above the 50th percentile) was 40 months. Patients with both markers below the median experienced the best clinical outcome (median progression-free survival not reached at 40 months). In conclusion, serum levels of either vascular endothelial growth factor or basic fibroblast growth factor are high in patients with early chronic lymphocytic leukaemia, however, only vascular endothelial growth factor predicts behaviour of disease and helps to refine the prognosis of stage A patients.

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Progression-free survival (PFS) of 81 stage A patients by serum concentration of β2-m and VEGF. The cut-offs used were median serum levels for both markers (VEGF, 203 pg ml−1; β2-m, 2.72 mg l−1). The plotted PFS lines from the top represent: Patients with both markers low; patients with one marker increased; patients with both markers increased.
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fig4: Progression-free survival (PFS) of 81 stage A patients by serum concentration of β2-m and VEGF. The cut-offs used were median serum levels for both markers (VEGF, 203 pg ml−1; β2-m, 2.72 mg l−1). The plotted PFS lines from the top represent: Patients with both markers low; patients with one marker increased; patients with both markers increased.

Mentions: Finally, given the partial independence of VEGF from β2-m the combined effect of these markers on DP of stage A patients was studied. Patients with both markers increased (above the median values) had the worst clinical outcome (median of PFS, 13 months) while those with both markers low the best one (median of PFS not reached at 44 months); in between there was an intermediate- risk group characterized for having only one marker increased (median of PFS, 40 months; χ2 for trend=13.04, d.f.=1, P=0.0003; Figure 4Figure 4


Clinicoprognostic implications of increased serum levels of vascular endothelial growth factor and basic fibroblastic growth factor in early B-cell chronic lymphocytic leukaemia.

Molica S, Vitelli G, Levato D, Ricciotti A, Digiesi G - Br. J. Cancer (2002)

Progression-free survival (PFS) of 81 stage A patients by serum concentration of β2-m and VEGF. The cut-offs used were median serum levels for both markers (VEGF, 203 pg ml−1; β2-m, 2.72 mg l−1). The plotted PFS lines from the top represent: Patients with both markers low; patients with one marker increased; patients with both markers increased.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2746542&req=5

fig4: Progression-free survival (PFS) of 81 stage A patients by serum concentration of β2-m and VEGF. The cut-offs used were median serum levels for both markers (VEGF, 203 pg ml−1; β2-m, 2.72 mg l−1). The plotted PFS lines from the top represent: Patients with both markers low; patients with one marker increased; patients with both markers increased.
Mentions: Finally, given the partial independence of VEGF from β2-m the combined effect of these markers on DP of stage A patients was studied. Patients with both markers increased (above the median values) had the worst clinical outcome (median of PFS, 13 months) while those with both markers low the best one (median of PFS not reached at 44 months); in between there was an intermediate- risk group characterized for having only one marker increased (median of PFS, 40 months; χ2 for trend=13.04, d.f.=1, P=0.0003; Figure 4Figure 4

Bottom Line: When dealing with basic fibroblast growth factor only a correlation with Rai sub-stages (P=0.02) could be found.Patients with both markers below the median experienced the best clinical outcome (median progression-free survival not reached at 40 months).In conclusion, serum levels of either vascular endothelial growth factor or basic fibroblast growth factor are high in patients with early chronic lymphocytic leukaemia, however, only vascular endothelial growth factor predicts behaviour of disease and helps to refine the prognosis of stage A patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Hematology, Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy. smolica@libero.it

ABSTRACT
To assess the relative merit of increased serum levels of vascular endothelial growth factor and basic fibroblastic growth factor in predicting the risk of disease progression of patients with early B-cell chronic lymphocytic leukaemia we analyzed 81 Binet stage A patients whose sera were taken at the time of diagnosis and evaluated for the presence of vascular endothelial growth factor and basic fibroblast growth factor using an enzyme-linked immunosorbent assay. Serum levels of vascular endothelial growth factor positively correlated with Rai sub-stages (P=0.03), peripheral blood lymphocytosis (P=0.03), bone marrow histology (P=0.04) and beta2-microglobulin (beta2-m) (P=0.006). When dealing with basic fibroblast growth factor only a correlation with Rai sub-stages (P=0.02) could be found. Different cut-offs set on the basis of a stratification in quartiles, failed to demonstrate any correlation between serum levels of basic fibroblast growth factor and disease progression. In contrast, patients with increased serum levels of vascular endothelial growth factor (above median value, 203 pg ml(-1)) had a three times increased risk of disease progression, although, in multivariate analysis only Rai sub-stages (P=0.0001) and lymphocyte doubling time (P=0.002) retained their prognostic significance. Low levels of vascular endothelial growth factor were indicative of good clinical outcome in the subgroup of patients with either low (P=0.02) or high (P=0.03) beta2-m concentration. Finally, the highest prognostic power was obtained when serum vascular endothelial growth factor and beta2-m were examined in combination. Median of progression-free survival of patients who had both serum vascular endothelial growth factor and beta2-m higher than median value was only 13 months, in contrast median progression-free survival of patients with one marker increased (i.e. above the 50th percentile) was 40 months. Patients with both markers below the median experienced the best clinical outcome (median progression-free survival not reached at 40 months). In conclusion, serum levels of either vascular endothelial growth factor or basic fibroblast growth factor are high in patients with early chronic lymphocytic leukaemia, however, only vascular endothelial growth factor predicts behaviour of disease and helps to refine the prognosis of stage A patients.

Show MeSH
Related in: MedlinePlus