Abstract
The proto‐oncogene NOTCH1 is frequently mutated in around 10% of patients with chronic lymphocytic leukemia (CLL). This study analyzed NOTCH1 mutation status of 317 Chinese patients with CLL by Sanger sequencing. The frequencies of NOTCH1 mutation in the PEST (proline (P), glutamic acid (E), serine (S), threonine (T)‐rich protein sequence) domain and the 3′ untranslated regions (UTR) were 8.2% and 0.9%, with the most frequent mutation being c.7541_7542delCT and c.*371A>G, respectively. Clinical and biological associations were determined including NOTCH1 mutations with advanced stage (Binet stage, P = 0.010), unmutated immunoglobulin heavy‐chain variable region (IGHV) gene (P < 0.001) and trisomy 12 (+12) (P = 0.014). NOTCH1‐mutated patients had lower CD20 expression intensity than NOTCH1‐unmutated patients (P = 0.029). In addition, NOTCH1‐mutated patients had shorter overall survival (OS) (P = 0.002) and treatment‐free survival (TFS) (P = 0.002) than NOTCH1‐unmutated patients, especially for patients with NOTCH1 c.7541_7542delCT and/or c.*371A>G mutations. Patients with both mutated NOTCH1 and unmutated IGHV had shorter OS (P < 0.001) and TFS (P < 0.001) than those with unmutated NOTCH1 or mutated IGHV. These data provide a comprehensive view of the clinical relevance and prognostic impact of NOTCH1 mutations on Chinese patients with CLL.
Highlights
Chronic lymphocytic leukemia (CLL) is a common type of B-cell chronic lymphoproliferative disorders in adults [1, 2]
We found that NOTCH1-mutated patients had lower CD20 expression intensity than unmutated patients (mean fluorescence intensity (MFI): 614.10 ± 430.71 vs. 951.84 ± 994.39, P = 0.029)
The mutation frequencies of PEST domain and noncoding domains were 8.2% and 0.9%, respectively, which were lower than those reported in Western countries [28]
Summary
Chronic lymphocytic leukemia (CLL) is a common type of B-cell chronic lymphoproliferative disorders in adults [1, 2]. Mainly in PEST (proline (P), glutamic acid (E), serine (S), threonine (T)-rich protein sequence) domain [10,11,12], are reported to occur in nearly 10% patients with CLL in Western countries [3, 13, 14]. In Western countries, NOTCH1 mutations have a significant association with unmutated IGHV [18]. It remains unclear that whether NOTCH1 mutations have a similar influence on Chinese patients with CLL as Western countries. In this retrospective study, we analyzed correlations between NOTCH1 mutations and other clinical and prognostic parameters in 317 Chinese patients with CLL. Survival analysis was performed based on NOTCH1 and other cytogenetic status
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