Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2020, 164(4):425-434 | DOI: 10.5507/bp.2019.046

Profiling of biological and environmental risk factors in immunogenetic subgroups of chronic lymphocytic leukemia - Czech national study

Kamila Stranskaa,b, Karla Plevovaa,b, Hana Skuhrova Francovaa, Hana Skabrahovaa, Magdalena von Jagwitz-Biegnitza, Lenka Radovab, Anna Panovskaa, Stanislava Hrobkovaa, Yvona Brychtovaa, Renata Urbanovac, Lukas Smolejd, Martin Simkovicd, Jana Zuchnickae, Lekaa Mohammadovaf, Martin Spacekg, Jiri Mayera, Sarka Pospisilovaa,b, Michael Doubeka,b
a Department of Internal Medicine - Hematology and Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
b Central European Institute of Technology, Masaryk University, Brno, Czech Republic
c Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
d 4th Department of Internal Medicine - Hematology, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
e Department of Hematooncology, University Hospital Ostrava, Czech Republic
f Department of Hematology and Oncology, University Hospital Pilsen, Czech Republic
g 1st Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic

Aims: This is a nation-wide survey of chronic lymphocytic leukemia (CLL) patients at six large hematology centers in the Czech Republic. The aim was to identify specific populations, social, and health characteristics of CLL subgroups divided according to the immunogenetic features of their B cell receptors (BCRs) and clonality.

Patients and Methods: Questionnaires directed to specific health, social, and environmental conditions were collected in a cohort of 573 CLL patients. For these patients, immunoglobulin heavy chain gene rearrangements were also analyzed in order to gain information about their clonality, IGHV mutational status, and the presence of stereotyped BCRs. Data extracted from the questionnaires were analyzed statistically in the context of immunogenetic features of the cohort.

Results: There were no statistically significant differences in the data collected in the survey between patients with mutated and patients with unmutated IGHV. However, patients with oligoclonal CLL reported health conditions such as hypercholesterolemia, hypertension, herpes simplex, tumors, and also, separately, CLL in 1st degree relatives, more often than their monoclonal counterparts. In patients with stereotyped BCRs, we found more frequent alcohol consumption and gastric infections in subset #1 cases and frequent cholecystectomies and familial CLL in subset #2 cases.

Conclusion: To the best of our knowledge, this study is the first to investigate CLL immunogenetic features and clonality in the context of epidemiological data. We reported statistically significant associations suggesting the influence of certain health and social conditions on a number of clonal populations expanding in CLL and also on characteristic BCR features, especially stereotypy.

Keywords: chronic lymphocytic leukemia, B-cell receptor, clonality, questionnaire, patient history, biological risk factor

Received: May 9, 2019; Revised: August 30, 2019; Accepted: September 4, 2019; Prepublished online: September 26, 2019; Published: December 15, 2020  Show citation

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Stranska, K., Plevova, K., Skuhrova Francova, H., Skabrahova, H., von Jagwitz-Biegnitz, M., Radova, L., ... Doubek, M. (2020). Profiling of biological and environmental risk factors in immunogenetic subgroups of chronic lymphocytic leukemia - Czech national study. Biomedical papers, 164(4), 425-434. doi: 10.5507/bp.2019.046
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