10 research outputs found
Outcomes for patients with chronic lymphocytic leukemia and acute leukemia or myelodysplastic syndrome
Hematological and Genetic Markers in the Rational Approach to Patients With HCV Sustained Virological Response With or Without Persisting Cryoglobulinemic Vasculitis
BACKGROUND AND AIMS: Direct鈥恆cting antivirals (DAAs) usually lead to improvement/remission of cryoglobulinemic vasculitis (CV), although symptoms may persist/recur after a sustained virological response (SVR). We evaluated hematological and genetic markers in patients with HCV鈥怱VR vasculitis with and without persisting/recurring symptoms to early predict the CV outcome. APPROACH AND RESULTS: Ninety鈥恊ight patients with HCV鈥怌V were prospectively enrolled after a DAA鈥恑nduced SVR: Group A: 52 with complete clinical response; Group B: 46 with symptom maintenance/recurrence. Monoclonal B鈥恈ell lymphocytosis, t(14;18) translocation, and abnormal free light chains 魏/位 ratios were detected by flow cytometry or nested鈥怭CR or nephelometry in 4% Group A versus 17% Group B (P聽=聽0.04) patients, 17% Group A versus 40% Group B patients (P聽=聽0.02), and 17% Group A versus 47% Group B (P聽=聽0.003) patients, respectively. At least 1 out of 3 clonality markers was altered/positive in 29% of Group A versus 70% of Group B patients (P聽<聽0.0001). When available, pretherapy samples were also tested for t(14;18) translocation (detected in 12/37 [32%] Group A and 21/38 [55%] Group B) and 魏/位 ratios (abnormal in 5/35 [14%] Group A and 20/38 [53%] Group B) (P聽=聽0.0006), whereas at least one clonality marker was detected/altered in 16/37 (43%) Group A and 30/38 (79%) Group B (P聽=聽0.002). CV鈥恆ssociated single鈥恘ucleotide polymorphisms were tested by real鈥恡ime PCR. Among them, notch4 rs2071286 T minor allele and TT genotype showed a higher frequency in Group B versus Group A (46% vs. 29%, P聽=聽0.01, and 17% vs. 2%, P聽=聽0.006, respectively). CONCLUSIONS: Hematological or genetic analyses could be used to foresee the CV clinical response after DAA therapy and could be valuable to assess a rational flowchart to manage CV during follow鈥恥p