Iron overload promotes the progression of MLL-AF9 induced acute myeloid leukemia by upregulation of FOS.

Systemic iron overload is a common clinical challenge leading to significantly serious complications in patients with acute myeloid leukemia (AML), which affects both the quality of life and the overall survival of patients. Symptoms can be relieved after iron chelation therapy in clinical practice. However, the roles and mechanisms of iron overload on the initiation and progression of leukemia remain elusive. Here we studied the correlation between iron overload and AML clinical outcome, and further explored the role and pathophysiologic mechanism of iron overload in AML by using two mouse models: an iron overload MLL-AF9-induced AML mouse model and a nude xenograft mouse model. Patients with AML had an increased ferritin level, particularly in the myelomonocytic (M4) or monocytic (M5) subtypes. High level of iron expression correlated with a worsened prognosis in AML patients and a shortened survival time in AML mice. Furthermore, iron overload increased the tumor load in the bone marrow (BM) and extramedullary tissues by promoting the proliferation of leukemia cells through the upregulation of FOS. Collectively, our findings provide new insights into the roles of iron overload in AML. Additionally, this study may provide a potential therapeutic target to improve the outcome of AML patients and a rationale for the prospective evaluation of iron chelation therapy in AML.

Simultaneous occurrence of multiple myeloma and acute myeloid leukemia: Case report and literature review.

Multiple myeloma (MM) and acute myeloid leukemia (AML) are malignant clonal diseases of cells in different lineages. It remains very rare to have both diseases at first diagnosis. Only 24 cases of this situation were reported from 1971 to 2021, and poor prognosis in most cases. However, here we describe a case of de novo MM and AML occurring simultaneously in a 65-year-old woman. We have successfully used individualized treatment regimens to allow the patient to survive 1.5 years to date, which has exceeded 80 % of statistical cases.

Eltrombopag modulates the phenotypic evolution and potential immunomodulatory roles of monocytes/macrophages in immune thrombocytopenia.

Primary immune thrombocytopenia (ITP) is an acquired autoimmune hemorrhagic disease. Loss of immune tolerance plays a crucial role in the pathogenesis of ITP. Monocytes and macrophages play an indispensable role in the pathophysiology of hematopoietic malignancies and have been implicated as key players in platelet destruction. Approximately 80% of adult patients with ITP exhibit corticosteroid treatment failure or become dependent, requiring novel therapy. Thrombopoietin (TPO) receptor agonists (TPO-RAs) have been used clinically to manage ITP effectively, however, little is known about the effect of TPO-RAs on monocyte and macrophage modulation in adult ITP. In this study, we investigated the phenotypic evolution and potential immunomodulatory roles of monocytes/macrophages in ITP patients receiving eltrombopag therapy. Results showed that the peripheral monocyte count positively correlated with IFN-γ/IL-4 ratio in ITP patients. Moreover, numerous phenotype-associated genes in ITP macrophages exhibited diverse responses, and ITP macrophages exhibited more M1-related characteristics. After eltrombopag therapy, the peripheral monocyte count and IFN-γ/IL-4 ratio significantly decreased in ITP patients. M1-related characteristics of ITP macrophages were partially reversed by eltrombopag. Therefore, this study revealed eltrombopag restored the monocyte dynamics and the associated Th1/Th2 imbalance, and partially reversed the M1-related characteristics of the ITP macrophages, which suggest the potential vital roles of TPO-RAs in regulating the monocyte/macrophage plasticity in ITP.

What is the context? Primary immune thrombocytopenia (ITP) is an acquired autoimmune hemorrhagic disease. Loss of immune tolerance plays a crucial role in the pathogenesis of ITP.Monocytes and macrophages play an indispensable role in the pathophysiology of hematopoietic malignancies and have been implicated as key players in platelet destruction.Approximately 80% of adult patients with ITP exhibit corticosteroid treatment failure or become dependent, requiring novel therapy. Thrombopoietin (TPO) receptor agonists (TPO-RAs) have been used clinically to manage ITP effectively, however, little is known about the effect of TPO-RAs on monocyte and macrophage modulation in ITP.What is new?In this study, we investigated the phenotypic evolution and potential immunomodula-tory roles of monocytes/macrophages in ITP patients receiving eltrombopag therapy.The expansion of peripheral monocytes positively correlated with IFN-γ/IL-4 ratio in ITP patients.ITP macrophages exhibited more M1-related characteristics.After eltrombopag therapy, the peripheral monocyte count and IFN-γ/IL-4 ratio significantly decreased in ITP patients.M1-related characteristics of ITP macrophages were partially reversed by eltrombopag.What is the impact?This study provides evidence that the potential vital roles of TPO-RAs in regulating the monocyte/macrophage plasticity in ITP.

One arrow for two targets: potential co-treatment regimens for lymphoma and HIV.

In 2007, an HIV-infected individual (Berlin patient) underwent two allogeneic haematopoietic stem cell transplantations (allo-HSCTs) from a donor with a homozygous mutation in the HIV co-receptor CCR5 (CCR5Δ32) for the treatment of acute myeloid leukaemia, which eradicated HIV from infected patients simultaneously. Ten years later, another success in the 'London patient' was reported. These two cases suggest that allo-HSCT from a suitable donor is feasible for the treatment of haematological malignancies and HIV. Moreover, other novel approaches for anti-lymphoma have effectively suppressed HIV replication, including chimeric antigen receptor T-cell (CAR-T) immunotherapy, PD-1/Programmed death-ligand-1 (PD-L1) blockade, and therapies based on mechanisms that target the critical molecular pathways of tumour. This review discusses these approaches for both lymphoma and anti-HIV therapy.

Design of a Sub-6 GHz Dielectric Resonator Antenna with Novel Temperature-Stabilized (Sm1-xBix)NbO4 (x = 0-0.15) Microwave Dielectric Ceramics.

Microwave dielectric ceramics exhibiting a low dielectric constant (εr), high quality factor (Q × f), and thermal stability, specifically in an ultrawide temperature range (from -40 to +120 °C), have attracted much attention. In addition, the development of 5G communication has caused an urgent demand for electronic devices, such as dielectric resonant antennas. Hence, the feasibility of optimizing the dielectric properties of the SmNbO4 (SN) ceramics by substituting Bi3+ ions at the A site was studied. The permittivity principally hinges on the contribution of Sm/Bi-O to phonon absorption in the microwave range, while the reduced sintering temperature results in a smaller grain size and slightly lower Q × f value. The expanded and distorted crystal cell indicates that Bi3+ doping effectively regulates the temperature coefficient of resonant frequency (TCF) by adjusting the strains (causing the distorted monoclinic structure) of monoclinic fergusonite besides correlating with the permittivity. Moreover, a larger A-site radius facilitates the acquisition of near-zero TCF values. Notably, the (Sm0.875Bi0.125)NbO4 (SB0.125N) ceramic with εr ≈ 21.9, Q × f ≈ 38 300 GHz (at ∼8.0 GHz), and two different near-zero TCF values of -9.0 (from -40 to +60 °C) and -6.6 ppm/°C (from +60 to +120 °C), respectively, were obtained in the microwave band. A simultaneous increase in the phase transition temperature (Tc) and coefficients of thermal expansion (CTEs) by A-site substitution provides the possibility for promising thermal barrier coating (TBC) materials. Then, a cylindrical dielectric resonator antenna (CDRA) with a resonance at 4.86 GHz and bandwidth of 870 MHz was fabricated by the SB0.125N specimen. The exceptional performance shows that the SB0.125N material is a possible candidate for the sub-6 GHz antenna owing to the advantages of low loss and stable temperature.

Combined multiomics analysis reveals the mechanism of CENPF overexpression-mediated immune dysfunction in diffuse large B-cell lymphoma in vitro.

Diffuse large B-cell lymphoma (DLBCL) is one of the most common aggressive B-cell lymphomas with significant heterogeneity. More than half of patients are cured, but 40%-45% still face relapse or develop drug resistance, and the mechanism is not yet known. In this study, Centrimeric protein F (CENPF) overexpression was found in several DLBCL patients with relapsed or refractory disease compared to patients with complete remission. Thus, the human DLBCL cell line SU-DHL-4 was chosen for this study, and CENPF was upregulated in that cell line by using an adenovirus in vitro. Mass spectrometry-based quantitative proteome analysis was first performed, and the results showed that the expression levels of various proteins were increased when CENPF was upregulated, and these proteins are mainly involved in cellular processes, biological regulation, immune system processes and transcriptional regulator activity. Bioinformatics data analysis revealed that the main enriched proteins, including UBE2A, UBE2C, UBE2S, TRIP12, HERC2, PIRH2, and PIAS, were involved in various ubiquitin-related kinase activities and ubiquitination processes. Thus, ubiquitinome analysis was further performed, and the results demonstrated that proteins in many immune-related cellular pathways, such as natural killer cell-mediated cytotoxicity, the T-cell receptor signaling pathway and the B-cell receptor signaling pathway, were significantly deubiquitinated after CENPF was upregulated in DLBCL cells. Furthermore, TIMER2.0 was also used to reveal the association between CENPF and immune infiltration in DLBCL. The results showed that CENPF expression was positively correlated with CD8+ T cells, NK cells and B lymphocytes in DLBCL samples but negatively correlated with regulatory T cells. Aberrant activation of CENPF may induce immune dysregulation in DLBCL cells by mediating protein deubiquitination in various immune signaling pathways, which leads to tumor escape of DLBCL, but further experimental validation is still needed.

Characteristics of macrophages from myelodysplastic syndrome microenvironment.

Myelodysplastic syndrome (MDS) is a heterogeneous group of clonal hematopoietic neoplasms. The progression of malignancy is closely associated with immune regulation. Macrophages are indispensable tissue components and have been proposed to play a role in the pathophysiology of hematopoietic malignancies. However, the specific role of macrophages in the development of MDS remains unclear. Here, we investigated the characteristics and phenotypic evolution of macrophages from patients with MDS. Macrophages from patients with MDS expressed CD68, CD86 and CD163. Furthermore, MDS macrophages exhibited more M2-related characteristics. Moreover, a number of phenotype-associated genes in MDS macrophages exhibited diverse responses to iron overload or iron chelation upon stimulation by ferric chloride or deferoxamine (DFO, an iron chelator). Ferric chloride polarized MDS macrophages to exhibit more M1-related characteristics, a phenomenon that could be partially reversed by DFO. Therefore, this study reveals the characteristics and phenotypic evolution of MDS macrophages and broadens the knowledge of macrophage plasticity in hematopoietic malignancies.

The iron chelator deferoxamine decreases myeloma cell survival.

OBJECTIVE: This study evaluated serum ferritin (SF) levels and investigated their relationships with various clinical markers in patients with multiple myeloma (MM). Furthermore, the effects and molecular mechanism of deferoxamine (DFO) in myeloma cells were studied. METHODS: Clinical data from 84 patients with MM were collected to evaluate SF content and its relationship with several important clinical parameters. MM1S and MM1R myeloma cells were chosen to investigate the effects of iron and DFO on cell survival and apoptosis. RESULTS: Increased SF levels were detected in newly diagnosed patients, especially those with stage III disease or the κ isotype. SF content was positively correlated with ß2-microglobulin, interleukin-6, and lactate dehydrogenase expression. Furthermore, patients with progressive or relapsed disease had higher SF levels. Importantly, iron chelation with DFO efficiently inhibited myeloma cell survival and accelerated apoptosis by regulating apoptosis-related genes. CONCLUSIONS: The importance of SF for MM was highlighted. Additionally, it is suggested that DFO may be a good therapeutic option for MM.

First Detection of Hb Cenxi [ß46(CD5)Gly→Arg (GGG>CGG), HBB: c.139G>C] by Capillary Electrophoresis.

We report a novel mutation on the ß-globin gene in a female of the Chinese population. This mutation produces a ß-globin variant that can be detected by the capillary electrophoresis (CE) method, but coelutes with Hb A2 by high performance liquid chromatography (HPLC). DNA sequencing showed a mutation of codon 46 and it was named Hb Cenxi [ß46(CD5)Gly→Arg (GGG>CGG), HBB: c.139G>C] for the city of birth of the proband. She presented normal hematological parameters.

Pretreatment lymphocyte-to-monocyte ratios predict AIDS-related diffuse large B-cell lymphoma overall survival.

The lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) have been reported to be useful for predicting the prognosis of various malignancies, including diffuse large B-cell lymphoma (DLBCL). However, little is known about the role of LMR and PLR in the prognosis of DLBCL patients with human immunodeficiency virus (HIV) infection. We retrospectively evaluated the prognostic value of the LMR and PLR in patients with newly diagnosed AIDS-related diffuse large B-cell lymphoma (AR-DLBCL) who were treated with CHOP-like chemotherapy at a single institution. In 33 AR-DLBCL patients, the median follow-up period was 32 months (range: 7-85 months), with an estimated 2-year overall survival (OS) rate of 79.9%. The univariate analysis confirmed the LMR ≤ 2.74 (p = .015), PLR ≥ 337.7 (p = .019), and moderate anemia (p = .045) were associated with inferior survival. The independent significant association between low LMR and poor OS in the multivariate analysis was identified (HR: 0.033, 95% CI: 0.001-0.853, p = .040). However, PLR (p = .459) and moderate anemia (p = .102) did not retain an independent significance in the multivariate analysis. Moreover, compared with the high-LMR group, patients with low-LMR more frequently had B symptoms (p = .010) and lower CD4+T cell count (p < .001). The pretreatment LMR may be an effective prognostic factor for predicting OS in patients with AR-DLBCL.

Detection of a Hb A2 -Melbourne (HBD: c.130G>A) combined with ß-thalassemia in a Chinese individual.

BACKGROUND: Thalassemia is common in Southeast Asian countries, including China. Hb A2 -Melbourne is a rare hemoglobin variant and has never been reported in China. Here, we report a Hb A2 -Melbourne combined with ß-thalassemia in Chinese individuals which is the second case described in the published reports. METHODS: Complete blood counts (CBC) of a 28-year-old female showed signs of thalassemia during a routine screening. Hemoglobin analysis was subsequently performed using capillary electrophoresis (CE) and high-performance liquid chromatography (HPLC). Four common deletional α-thalassemia detection was carried out using a gap-polymerase chain reaction (PCR). PCR and reverse dot-blot were used to detect three non-deletional α-thalassemia and 17 types of point mutations in ß-thalassemia. Finally, it was identified by Sanger sequencing. Her husband also had CBC, hemoglobin analysis, and genetic diagnosis. RESULTS: CBC of the couple showed Hb 103 and 139 g/L, mean corpuscular volume 58 and 63.1 fL, mean corpuscular hemoglobin 19.7 and 20.4 pg, respectively. Hemoglobin analysis revealed Hb X 2.4%, Hb A2 2.8% by CE and Hb X 2.9%, Hb A2 2.4% by HPLC in the female. The results of her husband were Hb A93.5%, Hb A2 5.7%, Hb F 0.8% by CE. Genetic analysis of both spouses detected the same CD 41/42 mutations in ß-globin gene. Sanger sequencing of female identified a mutation of the δ-globin gene (HBD:c.130G>A), corresponding to Hb A2 -Melbourne. CONCLUSION: Hb A2 -Melbourne can lead to misdiagnosis of ß-thalassemia. δ-globin gene mutation must be carefully examined in routine thalassemia screening.

Diffuse large B-cell lymphoma with pulmonary and cerebral involvement: A case report.

Primary diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma; however, the involvement of the lung and central nervous system (CNS) in patients with DLBCL is rare. Furthermore, patients with DLBCL rarely exhibit specific clinical symptoms, which may delay definitive diagnosis. The present study reports the case of a 42-year-old man suffering from primary DLBCL with concurrent pulmonary and cerebral involvement. The patient suffered from human immunodeficiency virus infection and presented with symptoms including dry cough, thoracalgia, intermittent mild fever and mild headache. Thoracic computed tomography scans revealed multiple pulmonary masses, and brain magnetic resonance imaging scans revealed nodules in the left frontal cortex and bilateral basal ganglia. A percutaneous lung needle biopsy test confirmed the diagnosis of DLBCL. In addition, positron emission tomography revealed the involvement of other parts of the body in DLBCL. The aim of the present study was to present the clinical, radiological and histological characteristics of the patient, which may aid physicians in diagnosing pulmonary and CNS involvement in DLBCL.

A rare case of multicentric castleman's disease transforms into multiple myeloma and its successful treatment.

Multicentric Castleman's disease (MCD) is a rare kind of lymphoproliferative disorder characterized by systemic problems such as frequent fever, fatigue and weight loss with angiofollicular lymph node hyperplasia. However, unlike unicentric Castleman's disease (UCD) with long-time survival by surgery and local radiotherapy, MCD remains poor prognosis due to no well-defined optimal treatment strategies and high risk of developing malignances especially lymphoma. We reported a case of MCD who received chemotherapy by ECHOP with unsatisfactory outcome and then oral administration with thalidomide combined with prednisone without disease progression after therapy. After 3 y, his MCD turned into multiple myeloma (MM) and accompanied by obvious response to combination of thalidomide with prednisone. Nowadays, there is no standard of therapy yet established for MCD. We successfully treated one such patient and found thalidomide based therapy may have a significant effect on MCD. We also proposed further researches with therapeutic potential about thalidomide for MCD.

Fast-Growing Subcutaneous Tumors with Lower-Extremity Edema and Rib Lesions: A Case of Non-Hodgkin's Lymphoma in an HIV-1-Infected Patient.

BACKGROUND Diffuse large B-cell lymphoma (DLBCL) accounts for the large majority of AIDS-related non-Hodgkin's lymphoma (NHL). DLBCL usually arises in lymph nodes, presenting as a painless rapid swelling mass in the neck, armpit, or groin. CASE REPORT Here, we report a case of DLBCL that needed only 3 months to develop a tumor 20×15 cm in diameter in the right groin and even caused scrotum swelling and lower-extremity edema. Furthermore, this case of DLBCL had developed other 3 subcutaneous tumors in the chest wall and their diameters were 16×9 cm, 7×7 cm, and 3×3 cm. A thoracic computed tomography (CT) scan presented with bilateral pleural effusion and the chest wall tumors with rib lesions. CONCLUSIONS It is rare that a DLBCL needed only 3 months to develop a tumor 20×15 cm in diameter and even caused scrotum swelling and unilateral lower-extremity edema due to the large mass located in the right groin. Furthermore, it is extremely rare that this lymphoma infiltrated the chest wall and even resulted in rib lesions.

The progress and current status of immunotherapy in acute myeloid leukemia.

Recently, there has been remarkable progress in basic and preclinical studies of acute myeloid leukemia (AML). The improved outcomes of AML can largely be attributed to advances in supportive care and hematopoietic cell transplantation as opposed to conventional chemotherapy. However, as the 5-year survival rate remains low due to a high incidence of relapse, novel and effective treatments are urgently needed. Increasing attention is focusing on identifying suitable immunotherapeutic strategies for AML. Here, we describe the immunological features, mechanisms of immune escape, and recent progress in immunotherapy for AML. Problems encountered in the clinic will also be discussed. Although current outcomes may be limited, ongoing preclinical or clinical efforts are aimed at improving immunotherapy modalities and designing novel therapies, such as vaccines, monoclonal antibody therapy, chimeric antibody receptor-engineered T cells (CAR-T), TCR-engineered T cells (TCR-T), and checkpoint inhibitors, which may provide promising and effective therapies with higher specificity and efficacy for AML.

Elevated serum ferritin levels in patients with hematologic malignancies.

PURPOSE: To retrospectively analyze variability and clinical significance of serum ferritin levels in Chinese patients with hematologic malignancies. MATERIALS AND METHODS: Serum ferritin were measured by radioimmunoassay, using a kit produced by the Beijing Institute of Atomic Energy. Patients with hematologic malignancies, and treated in the Department of Hematology in Nanjing First Hospital and fulfilled study criteria were recruited. RESULTS: Of 473 patients with hematologic malignancies, 262 patients were diagnosed with acute leukemia, 131 with lymphoma and 80 with multiple myeloma. Serum ferritin levels of newly diagnosed and recurrent patients were significantly higher than those entering complete remission stage or in the control group (p<0.001). CONCLUSIONS: Serum ferritin lever in patients with hematologic malignancies at early stage and recurrent stage are significantly increased, so that detection and surveillance of changes of serum ferritin could be helpful in assessing conditions and prognosis of this patient cohort.

Bortezomib in combination with thalidomide or lenalidomide or doxorubicin regimens for the treatment of multiple myeloma: a meta-analysis of 14 randomized controlled trials.

The aim of the study was to evaluate the clinical efficacy and safety of bortezomib-based regimens for the treatment of multiple myeloma through meta-analysis. The literature on three classes of bortezomib-based regimens - bortezomib and thalidomide (VT), bortezomib and lenalidomide (VR) and bortezomib and doxorubicin (VD) - was systematically retrieved and analyzed. The initial search yielded 4896 citations, of which 14 randomized controlled trials (RCTs) (a total of 5379 patients enrolled) met the pre-specified inclusion criteria. The results indicated that the VT regimen had an improved benefit in complete remission (CR) and overall response rate (ORR), but not in progression-free survival (PFS), overall survival (OS) and major grade III/IV adverse events such as peripheral neuropathy, thrombotic events and infection. In contrast, the VD regimen had an improved CR with fewer thrombotic events, while PFS, OS, ORR and the other adverse events showed no significant difference. No significant difference was observed in CR, ORR and major grade III/IV adverse events when comparing the VR regimen with bortezomib and cyclophosphamide (VC), but patients receiving VR regimen therapy had obviously longer PFS and OS.

[Methylation of FHIT gene promoter region in DNA from plasma of patients with myelodysplastic syndromes and demethylating effect of decitabine].

This study was aimed to detect the methylation status of FHIT gene promoter region in the DNA from plasma of patients with myelodysplastic syndrome (MDS), and to investigate the demethylating effect of decitabine. Methylation-specific PCR method was used to detect the methylation status of FHIT gene promoter region in the DNA from plasma of 4 patients with MDS before and after treatment with decitabine plus semis CAG therapy (among them, 1 case of newly diagnosed MDS, 3 cases progressed into acute leukemia). The results indicated that 3 cases were found to have an increased methylation in the promoter region. After treatment with decitabine plus semis CAG, increased methylation was reversed in 2 cases. In 4 cases, 2 cases displayed clinical response. It is concluded that FHIT gene hypermethylation is associated with MDS pathogenesis. Decitabine has demethylating effect on the FHIT gene hypermethylation of plasma from MDS patients. Detecting the methylation status of FHIT gene in DNA from plasma may play a role in MDS auxiliary diagnosis or prognosis.

Phase II study on voriconazole for treatment of Chinese patients with malignant hematological disorders and invasive aspergillosis.

OBJECTIVE: To investigate the efficacy and safety of voriconazole in treating Chinese patients with hematological malignancies and invasive aspergillosis. METHODS: From March 2007 to April 2012, patients with diagnoses confirmed by CT, GM test and/or PCR assays, were recruited into this study. Aspergillosis of all patients were treated with voriconazole 6 mg/kg intravenous infusion (iv) every 12 h for 1 day, followed by 4 mg/kg IV every 12 h for 10-15 days; Then, switch to oral administration that was 200 mg every 12 h for 4-12 weeks. Efficacy and safety were evaluated according to Practice Guideline of Infectious Diseases Society of America. RESULTS: The overall response rate of 38 patients after voriconazole treatment was 81.6%. The median time to pyretolysis was 4.5 days. Treatment related side effects were mild and found in only 15.8% of cases. No treatment related deaths occurred. CONCLUSIONS: Voriconazole can considered to be a safe and effective front-line therapy to treat patients with hematological malignancies and invasive aspergillosis. Alternatively it could be used as a remedial treatment when other antifungal therapies are ineffective.

[Detection of molecular cytogenetic abnormalities in 30 patients with chronic lymphocytic leukemia by fluorescence in situ hybridization].

This study was aimed to investigate the significance of interphase fluorescence in situ hybridization (FISH) in detecting +12, del (13q14), p53 and atm gene deletion in chronic lymphocytic leukemia (CLL). FISH and a panel of probes (CEP 12, LSI D13S319, LSI p53, LSI atm) were used to detect molecular cytogenetic abnormalities in 30 patients with CLL. Cytogenetic aberrations and their relation with some other prognostic factors (peripheral lymphocyte count, Binet stage, LDH level, ZAP-70 and so on) were analyzed. The results indicated that out of the 30 CLL patients, molecular cytogenetic aberrations were found in 19 (63.3%) cases and 7 (23.3%) patients showed more than two kinds of abnormalities. The most frequent abnormality detected was del (13q14) (43.3%), followed by trisomy of chromosome 12 (23.3%), del (atm) (13.3%) and del (p53) (10.0%). There were no significant differences between molecular cytogenetic aberrations and sex, age, Binet stage, peripheral lymphocyte count, or the serum levels of lactate dehydrogenase (LDH), beta(2)-microglobulin (beta(2)-MG), or ZAP-70. The incidence of atm gene deletion was higher in the group of CD38 high expression than that in the group of low expression (p = 0.035). It is concluded that FISH is a rapid and sensitive technique in analysing molecular cytogenetic abnormalities, but its prognostic significance in CLL needs to further investigate.