-1 Gene Expression is a Reliable Prognostic Indicator in Egyptian Patients with Chronic Lymphocytic Leukemia: A Prospective Cohort Study.

Objective: Traditional prognostic factors have proved insufficient to account for heterogeneity in the clinical behavior of chronic lymphocytic leukemia (CLL). -1 () is a circadian clock gene essential in maintaining the circadian rhythm and regulating cell proliferation. We evaluated  gene expression in CLL and addressed its putative role as a prognostic indicator for the clinical course of CLL.

Materials And Methods: A total of 100 CLL patients at diagnosis were studied for  gene expression by real-time reverse-transcription polymerase chain reaction and were followed for assessment of time to first treatment (TFT).

Results:  was expressed in 94% of the CLL patients at diagnosis. The median  relative gene expression level (0.006) stratified patients into high and low expression groups. Forty of 100 (40%) CLL patients showed high , 54/100 (54%) showed low , and 6/100 (6%) had undetectable  gene expression. High  gene expression was concordant with CD38, Zap-70, and double CD38Zap-70 expression; unfavorable/intermediate cytogenetics; unmutated  gene; and diffuse marrow infiltration. The high  gene expression patient group exhibited shorter TFT than the patients with low  gene expression. A Cox proportional hazard regression model identified  gene expression to be independently predictive for TFT.

Conclusion:  is differentially expressed among CLL patients, stratifying them into low-risk and high-risk groups.  gene expression could constitute a reliable prognostic indicator for CLL progression, complementing the role of standard well-established prognostic factors.  gene expression could be employed as a prognostic indicator for disease progression during the initial prognostic work-up and follow-up for CLL patients.