CLL-032: Approach Strategies in the Diagnosis and Evolution of Chronic Lymphocytic Leukemia

Abstract

Context: CLL is a neoplasm of mature B-cells that is typically manifested within the peripheral blood. The risk of progression to overt CLL for low-count MBL, however, is unknown, and, to date, no cases of low-count MBL progressing to CLL have been reported. Objective: It was discovered in the last few years that the production of some percentage of mutant p-53 proteins, with the increased stability in type B lymphocytes, leads to the carcinogenesis process. The aim of this study was to apply the sandwich enzyme-linked immunosorbent assay (sandwich ELISA), as screening method in discovery early stagy of CLL with isoform p-53 protein, resisted in the oncologic conventional treatment. Design: The monoclonal antibody PAb 240 recognizes an epitope that is structurally hidden in the wild-type conformation of p-53 and becomes exposed by denaturing the p-53 protein or the mutant conformations of p-53, where point mutations in the P-53 gene alter the terminal structure of the p-53 protein. Setting: In the context of a heterogeneous malignant disease, such as CLL-B, this simple and inexpensive ELISA method, such as employed in this study, proves useful for identifying patients to be considered as candidates for personalized therapeutic strategies, based on the mutation of the TP- 53 gene and the presence of p-53 isoform protein. Conclusions: The presented research has an impact on the clinical management of patients and requires adequate therapeutic adaptation in a personalized medicine. Personalized treatments will be applied by combining diagnostic tools, immunohistochemistry (IHC), polymerase chain reaction (PCR), single-chain peptide microarray (SSPMa), next-generation sequencing (NGS), knowledge databases and therapeutic drugs.