Should a positive direct antiglobulin test be considered a prognostic predictor in chronic lymphocytic leukemia?

Clin Lymphoma Myeloma Leuk. 2013 Aug;13(4):441-6. doi: 10.1016/j.clml.2013.02.024. Epub 2013 Jun 14.

Abstract

Background: The clinical course of patients with B-cell CLL is often complicated by autoimmune phenomena. The DAT might be positive at some time during the course of the disease in up to 35% of cases. The aim of this retrospective study was to investigate the relationship between the occurrence of a positive DAT and biological features of CLL patients.

Patients and methods: In our institution, 146 untreated patients with CLL were studied using the DAT.

Results: According to the statistical analysis, a high level of β2-microglobulin and unmutated IgHV emerged as factors significantly related to the presence of DAT positivity. Time to first TFS was significantly shorter in DAT-positive patients. The adverse effect of a DAT positive result was maintained in terms of TFS when patients with mutated IgHV status were excluded from statistical analysis.

Conclusion: These results suggest that the DAT might provide additional prognostic information regarding patients with IgHV unmutated status.

Keywords: Autoimmune phenomena; Hemolytic anemia; IgHV unmutated status; Lymphoproliferative diseases; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coombs Test / instrumentation
  • Coombs Test / methods*
  • Female
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / diagnosis*
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies