{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:49:51Z","timestamp":1791355791525,"version":"4.3.1"},"reference-count":34,"publisher":"American Society of Hematology","issue":"12","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2003,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The immunoglobulin variable heavy chain (IgVH) gene mutation status is an important prognostic factor in chronic lymphocytic leukemia (CLL), since cases with mutated VH genes show significantly longer survival than unmutated cases. Recently, we reported a preferential use of the VH3-21 gene in mutated CLL and showed that mutated VH3-21 cases had an inferior overall survival compared with other mutated CLL. In order to further characterize this subset, we performed VH gene analysis in 265 CLL cases and identified 31 VH3-21 cases (11.7%); 21 cases had mutated and 10 cases unmutated VH genes. Regardless of VH gene mutation status, a poor overall survival was found in the VH3-21 cases with a median survival of 83 months. These survival data confirm that VH3-21 cases do not fit into the general prognostic grouping of mutated and unmutated CLL. A large fraction of VH3-21 cases also demonstrated unique features with shorter lengths of the third complementarity determining region (CDR3) and CDR3s with highly homologous amino acid sequences. Furthermore, the VH3-21 cases showed a striking dominance of \u03bb light chain expression, and analysis of the Ig\u03bb gene rearrangements revealed highly restricted use of the V\u03bb2-14\/J\u03bb3 genes in the majority of cases. Taken together, our new findings strengthen the suggestion that VH3-21\u2013using cases comprise a new CLL entity, irrespective of VH gene mutation status, and implicate that a common antigen epitope, perhaps of pathogenic significance, is recognized by the highly homologous VH3-21\/V\u03bb2-14 Ig molecules expressed in individual tumors.<\/jats:p>","DOI":"10.1182\/blood-2002-11-3485","type":"journal-article","created":{"date-parts":[[2003,2,18]],"date-time":"2003-02-18T01:22:51Z","timestamp":1045531371000},"page":"4952-4957","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":261,"title":["Chronic lymphocytic leukemias utilizing the VH3-21 gene display highly restricted V\u03bb2-14 gene use and homologous CDR3s: implicating recognition of a common antigen epitope"],"prefix":"10.1182","volume":"101","author":[{"given":"Gerard","family":"Tobin","sequence":"first","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Thunberg","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Johnson","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inger","family":"Eriksson","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"So\u0308derberg","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karin","family":"Karlsson","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mats","family":"Merup","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunnar","family":"Juliusson","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhani","family":"Vilpo","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gunilla","family":"Enblad","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christer","family":"Sundstro\u0308m","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Go\u0308ran","family":"Roos","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; the Department of Medical Biosciences, Pathology, Umea\u030a University, Sweden; the Department of Hematology, Linko\u0308ping University Hospital, Sweden; the Department of Hematology, Huddinge University Hospital, Sweden; and the Department of Clinical Chemistry, Tampere University Hospital and Helsinki University Central Hospital (Jorvi Hospital), Finland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Rosenquist","sequence":"additional","affiliation":[{"name":"From the Departments of Genetics and Pathology, and Oncology, Radiology and Clinical Immunology, Uppsala University, Sweden; 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