Abstract
Search for new prognostic markers in order to improve prognostic accuracy and predict clinical outcome at the time of diagnosis has recently become one of the major trends in chronic lymphocytic leukemia (CLL). The aim of our study was assessment of selected markers of apoptosis and angiogenesis and their potential as new prognostic factors.
We evaluated serum levels of tumor necrosis factor a (TNF‑a) and transforming growth factor b‑ 1 (TGF‑b1); furthemore, we quantified expression of type II receptor for transforming growth factor beta (TGFbRII) and type 2 receptor for fibroblast growth factor‑ 2 (FGFR2) in 75 previously untreated patients with CLL. We found significantly elevated TNF‑a in patients with CLL compared to the control group; high expression of TNF‑a was associated with unfavourable prognosis (with Rai high‑risk group, high serum b2- microglobulin, massive lymphadenopathy, unmutated IgVH genes, unfavourable cytogenetic aberrations, progressive CLL, shorter time to treatment).
Higher TGF‑b1 concentrations were associated with favourable subgroups ( with Rai low‑ risk group, with patients without massive lymphadenopathy, mutated IgVH genes, ZAP‑ 70 negativity, stable clinical course, longer time to treatment). Based on our results, TNF‑a and TGF‑b1 possess prognostic significance in CLL; further research in this direction may also be important therapeutically,because these signal pathways could serve as possible treatment targets.