{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:12:14Z","timestamp":1790673134349,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T00:00:00Z","timestamp":1525824000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ligue Nationale Contre le Cancer, \u00e9quipe labellis\u00e9e Ligue"},{"name":"Comit\u00e9 Orientation Recherche Cancer en Limousin"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2018,6]]},"abstract":"Abstract<\/jats:title>More than 35\u00a0years after the Binet classification, there is still a need for simple prognostic markers in chronic lymphocytic leukemia (CLL<\/jats:styled-content>). Here, we studied the treatment\u2010free survival (TFS<\/jats:styled-content>) impact of normal serum protein electrophoresis (SPE<\/jats:styled-content>) at diagnosis. One hundred twelve patients with CLL<\/jats:styled-content> were analyzed. The main prognostic factors (Binet stage; lymphocytosis; IGHV<\/jats:styled-content> mutation status; TP<\/jats:styled-content>53<\/jats:italic>, SF<\/jats:styled-content>3B1<\/jats:italic>, NOTCH<\/jats:styled-content>1,<\/jats:italic> and BIRC<\/jats:styled-content>3<\/jats:italic> mutations; and cytogenetic abnormalities) were studied. The frequencies of IGHV<\/jats:styled-content> mutation status, cytogenetic abnormalities, and TP<\/jats:styled-content>53<\/jats:italic>, SF<\/jats:styled-content>3B1<\/jats:italic>, NOTCH<\/jats:styled-content>1,<\/jats:italic> and BIRC<\/jats:styled-content>3<\/jats:italic> mutations were not significantly different between normal and abnormal SPE<\/jats:styled-content>. Normal SPE<\/jats:styled-content> was associated with Binet stage A, nonprogressive disease for 6\u00a0months, lymphocytosis below 30\u00a0G\/L, and the absence of the IGHV<\/jats:styled-content>3\u201021 gene rearrangement which is associated with poor prognosis. The TFS<\/jats:styled-content> of patients with normal SPE<\/jats:styled-content> was significantly longer than that of patients with abnormal SPE<\/jats:styled-content> (log\u2010rank test: P<\/jats:italic>\u00a0=\u00a00.0015, with 51% untreated patients at 5.6\u00a0years and a perfect plateau afterward vs. a median TFS<\/jats:styled-content> at 2.64\u00a0years for abnormal SPE<\/jats:styled-content> with no plateau). Multivariate analysis using two different Cox models and bootstrapping showed that normal SPE<\/jats:styled-content> was an independent good prognostic marker for either Binet stage, lymphocytosis, or IGHV<\/jats:styled-content> mutation status. TFS<\/jats:styled-content> was further increased when both normal SPE<\/jats:styled-content> and mutated IGHV<\/jats:styled-content> were present (log\u2010rank test: P<\/jats:italic>\u00a0=\u00a00.008, median not reached, plateau at 5.6\u00a0years and 66% untreated patients). A comparison with other prognostic markers suggested that normal SPE<\/jats:styled-content> could reflect slowly advancing CLL<\/jats:styled-content> disease. Altogether, our results show that a combination of normal SPE<\/jats:styled-content> and mutated IGHV<\/jats:styled-content> genes defines a subgroup of patients with CLL<\/jats:styled-content> who evolve very slowly and who might never need treatment.<\/jats:p>","DOI":"10.1002\/cam4.1510","type":"journal-article","created":{"date-parts":[[2018,5,9]],"date-time":"2018-05-09T23:18:54Z","timestamp":1525907934000},"page":"2621-2628","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Normal serum protein electrophoresis and mutated IGHV<\/scp> genes detect very slowly evolving chronic lymphocytic leukemia patients"],"prefix":"10.1002","volume":"7","author":[{"given":"Jasmine","family":"Chauzeix","sequence":"first","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"},{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Pierre","family":"Lafor\u00eat","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e9lanie","family":"Deveza","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liam","family":"Crowther","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elodie","family":"Marcellaud","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paco","family":"Derouault","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges EA6309 Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne\u2010Sophie","family":"Lia","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges EA6309 Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fran\u00e7ois","family":"Boyer","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Bargues","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Olombel","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"},{"name":"Immunologie Centre Hospitalier Universitaire de Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Jaccard","sequence":"additional","affiliation":[{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"},{"name":"H\u00e9matologie Clinique et Th\u00e9rapie Cellulaire Centre Hospitalier Universitaire de Limoges Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6223-2454","authenticated-orcid":false,"given":"Jean","family":"Feuillard","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"},{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Gachard","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"},{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rizzo","sequence":"additional","affiliation":[{"name":"H\u00e9matologie Biologique Centre Hospitalier Universitaire de Limoges Limoges France"},{"name":"Facult\u00e9 de M\u00e9decine de Limoges UMR CNRS 7276 CRIBL Limoges France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,5,9]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"WHO classification of tumours of haematopoietic and lymphoid tissues","author":"Swerdlow S. 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