Males have a worse prognosis than females in chronic lymphocytic leukemia and this may be related to IgVH gene usage and mutational status.
Notice bibliographique
Résumé
2211 It has been suggested that women have a better prognosis than men in chronic lymphocytic leukemia (CLL) and this could be related to hormonal or cellular differences. To assess the sex differences in CLL we have carried out a population-based study in Manitoba (pop. 1.2 million) in which we have identified all patients diagnosed with CLL or small lymphocytic lymphoma (SLL) from 01/01/1998 to 12/31/2003. Patients were identified through the Manitoba Cancer Registry with ICD codes 9 and 10 for CLL or SLL and by our centralized flow cytometry facility. 636 pts were identified (incidence, 88 pts/million/annum); the median age at diagnosis was 71 yrs with a male:female ratio of 1.3:1. There was a predominance of men to women until the age of 70 yrs and a predominace of females thereafter. The median age at diagnosis was higher for women than for men (73 vs 70 yrs, P=0.04). Moreover, women had a better prognosis than men, with the 5 year relative survival being 90% compared with 70% for men. The difference in survival increased with age being most marked in patients >75 yrs old. To examine the cause for this difference, we evaluated cellular prognostic indicators in males and females. Poor prognostic markers include unmutated IgVH, use of certain IgVH genes, eg. VH1-69 and VH3-21, ZAP-70 positivity, CD38 positivity and del 17p13 (p53 mutation). Of >300 pts followed in the CancerCare Manitoba CLL clinic 101 have to date been studied (66 male, 35 female). Overall, there was a predominance of IgVH mutated cases with the mutated:unmutated ratio being 1.6:1. There was a predominance of mutated cases in female patients with the mutated: unmutated ratio being 2.2:1, compared with 1.4:1 in males. Of the twelve VH1-69 cases, 9 were male and 3 female, and of the five VH3-21 cases, all were male. In addition, there was a predominance of ZAP-70 positivity in males compared to females, but no difference was noted in CD38 status, in vitro sensitivity to chlorambucil or fludarabine (as measured by MTT assay) or in the incidence of del 17p13 (as measured by FISH). To determine whether there was a difference in plasma to explain the sex differences, male or female CLL cells were incubated in male or female plasma and spontaneous or drug-induced apoptosis measured by acridine orange staining. To date, no consistent difference has been observed between male and female plasma. Thus, the worse prognosis for males with CLL may be related to a bias in IgVH gene usage by men and an increased likelihood of being unmutated. Further patients are being studied to confirm these findings.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».