Hematology
Contributions
Type: Publication Only
Background
Perivascular leukocyte infiltrates and endothelial damage are vital in the development of chronic lymphocytic leukemia. As cell-to-cell interactions are critical in the processes of chronic lymphocytic leukemia, galectin-3 have become of interest as novel regulators of inflammation. Galectin-3 is produced by activated macrophages and it is predominantly expressed in subclinical atherosclerosis, unstable and stable coronary artery disease, heart failure. Therefore, galectin-3 is not only key player in inflammation and as well as in tumor progression by displaying intracellular and extracellular activities. However, the predictive role of galectin-3 in stable patients with chronic lymphocytic leukemia in remission is not understood.
Aims
Evaluate the prognostic value of circulating galectin-3 for cumulative survival in patients with chronic lymphocytic leukemia in remission.
Methods
One hundred fifty six out subjects with chronic lymphocytic leukemia in full or partial remission were enrolled in the study. Diagnosis and staging of chronic lymphocytic leukemia were defined by current clinical practice guidelines. All subjects gave their written informed consent to participation in the study. Observation period was up to 12 months. Blood samples for biomarkers measurements were collected. ELISA method for measurements of circulating level of galectin-3 was used. Hemodynamic evaluation was performed by transthoracic echocardiography. Echocardiography in B-mode was performed accordingly to Recommendation of American Society of Echocardiography on the scanner “MyLab 50” (Italy) using a transducer with a frequency of 2.5-3.5 MHz.
Results
Two hundred sixteen cumulative clinical events occurred in 51 patients (32,7%) within the follow-up, with their distribution being as follows: 7 deaths, 122 cardiac arrhythmias, 16 cardiac ischemic events, 3 strokes, 30 chronic heart failures and 38 hospital admissions for cardiovascular reasons.
Medians of circulating levels of galectin-3 in free-events subject cohort and subjects cohort with cardiovascular events were 5,16 ng/ml (95% confidence interval [CI] = 4,74-5,56 ng/ml) and 16,40 ng/ml (95% CI = 14,80-18,01 ng/ml) (p<0.001). In multivariate logistic regression circulating VE-catherin independently predicted cumulative cardiovascular events (odds ratio [OR] = 1,13; 95% CI = 1,07–1,25; p = 0.003) within 12 months of observation period.
Results of the study showed that exaggerated circulating level of galectin-3 in patients with chronic lymphocytic leukemia in remission may consider biomarker with power predictive value for cardiovascular events whether for tumor progression did not. Probably it may be related with small size of the study or short-term period of the observation. However, association of galectin-3 with tumor progression was not found. Author think that it is needed more studies with higher statistical power to be recognized prognostic potential of Gal-3 in two directions: cardiovascular outcomes and tumor progression.
Summary
Among patients with chronic lymphocytic leukemia in remission increased circulating galectin-3 associates with increased cumulative cardiovascular events within 12 months.
Keyword(s): Chronic lymphocytic leukemia, Prognostic factor
Type: Publication Only
Background
Perivascular leukocyte infiltrates and endothelial damage are vital in the development of chronic lymphocytic leukemia. As cell-to-cell interactions are critical in the processes of chronic lymphocytic leukemia, galectin-3 have become of interest as novel regulators of inflammation. Galectin-3 is produced by activated macrophages and it is predominantly expressed in subclinical atherosclerosis, unstable and stable coronary artery disease, heart failure. Therefore, galectin-3 is not only key player in inflammation and as well as in tumor progression by displaying intracellular and extracellular activities. However, the predictive role of galectin-3 in stable patients with chronic lymphocytic leukemia in remission is not understood.
Aims
Evaluate the prognostic value of circulating galectin-3 for cumulative survival in patients with chronic lymphocytic leukemia in remission.
Methods
One hundred fifty six out subjects with chronic lymphocytic leukemia in full or partial remission were enrolled in the study. Diagnosis and staging of chronic lymphocytic leukemia were defined by current clinical practice guidelines. All subjects gave their written informed consent to participation in the study. Observation period was up to 12 months. Blood samples for biomarkers measurements were collected. ELISA method for measurements of circulating level of galectin-3 was used. Hemodynamic evaluation was performed by transthoracic echocardiography. Echocardiography in B-mode was performed accordingly to Recommendation of American Society of Echocardiography on the scanner “MyLab 50” (Italy) using a transducer with a frequency of 2.5-3.5 MHz.
Results
Two hundred sixteen cumulative clinical events occurred in 51 patients (32,7%) within the follow-up, with their distribution being as follows: 7 deaths, 122 cardiac arrhythmias, 16 cardiac ischemic events, 3 strokes, 30 chronic heart failures and 38 hospital admissions for cardiovascular reasons.
Medians of circulating levels of galectin-3 in free-events subject cohort and subjects cohort with cardiovascular events were 5,16 ng/ml (95% confidence interval [CI] = 4,74-5,56 ng/ml) and 16,40 ng/ml (95% CI = 14,80-18,01 ng/ml) (p<0.001). In multivariate logistic regression circulating VE-catherin independently predicted cumulative cardiovascular events (odds ratio [OR] = 1,13; 95% CI = 1,07–1,25; p = 0.003) within 12 months of observation period.
Results of the study showed that exaggerated circulating level of galectin-3 in patients with chronic lymphocytic leukemia in remission may consider biomarker with power predictive value for cardiovascular events whether for tumor progression did not. Probably it may be related with small size of the study or short-term period of the observation. However, association of galectin-3 with tumor progression was not found. Author think that it is needed more studies with higher statistical power to be recognized prognostic potential of Gal-3 in two directions: cardiovascular outcomes and tumor progression.
Summary
Among patients with chronic lymphocytic leukemia in remission increased circulating galectin-3 associates with increased cumulative cardiovascular events within 12 months.
Keyword(s): Chronic lymphocytic leukemia, Prognostic factor