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Lag-times between lympho-proliferative disorder and clinical diagnosis of chronic lymphocytic leukemia (CLL): a prospective analysis using plasma soluble CD23.

In English

Författare

  • Rudolf Kaaks
  • Disorn Sookthai
  • Anna Luczynska
  • Christopher Charles Oakes
  • Susen Becker
  • Theron Johnson
  • Ann Sofie Johansson
  • Beatrice Melin
  • Klas Sjöberg
  • Dimitrios Trichopoulos
  • Antonia Trichopoulou
  • Pagona Lagiou
  • Amalia Mattiello
  • Rosario Tumino
  • Giovanna Masala
  • Claudia Agnoli
  • Heiner Boeing
  • Krasimira Aleksandrova
  • Paul Brennan
  • Silvia Franceschi
  • Sandrine Roulland
  • Delphine Casabonne
  • Silvia de Sanjose
  • Maria-Jose Sanchez
  • Jose-Maria Huerta
  • Eva Ardanaz
  • Nuria Sala
  • Kim Overvad
  • Anne Tjonneland
  • Jytte Halkjær
  • Elisabete Weiderpass
  • H Bas Bueno-de-Mesquita
  • Roel Vermeulen
  • Petra H Peeters
  • Paolo Vineis
  • Rachel S Kelly
  • Kay-Tee Khaw
  • Ruth C Travis
  • Timothy J Key
  • Elio Riboli
  • Alexandra Nieters
Visa allt

Summary, in English

Background:CLL is a chronic disease that often progresses slowly from a precursor stage, monoclonal B-cell lymphocytosis (MBL), and that can remain undiagnosed for a long time. Methods:Within the European EPIC cohort, we measured pre-diagnostic plasma sCD23 for 179 individuals who eventually were diagnosed with CLL and an equal number of matched control subjects who remained free of cancer. Results: In a very large proportion of CLL patients plasma sCD23 was clearly elevated 7 or more years before diagnosis. Considering sCD23 as a disease predictor, the area under the ROC curve (AUROC) was 0.95 [95% CI (0.90, 1.00)] for CLL diagnosed within 0.1-2.7 years after blood measurement, 0.90 [0.86-0.95] for diagnosis within 2.8-7.3 years, and 0.76 [0.65-0.86] for CLL diagnosed between 7.4 and 12.5 years. Even at a 7.4-year and longer time interval, elevated plasma sCD23 could predict a later clinical diagnosis of CLL with 100% specificity at >45% sensitivity. Conclusions:Our findings provide unique documentation for the very long latency times during which measurable B-cell lympho-proliferative disorder exists prior to the clinical manifestation of CLL. Impact:Our findings have relevance for the interpretation of prospective epidemiologic studies on the causes of CLL in terms of reverse causation bias. The lag-times indicate a time frame within which an early detection of CLL would be theoretically possible.

Avdelning/ar

Publiceringsår

2015

Språk

Engelska

Sidor

538-545

Publikation/Tidskrift/Serie

Cancer Epidemiology Biomarkers & Prevention

Volym

24

Issue

3

Dokumenttyp

Artikel i tidskrift

Förlag

American Association for Cancer Research

Ämne

  • Cancer and Oncology

Status

Published

Forskningsgrupp

  • Gastroenterology

ISBN/ISSN/Övrigt

  • ISSN: 1538-7755