Is Apolipoprotein A of Prognostic and Therapeutic Value in Patients With CLL?
Posted: Friday, September 17, 2021
Xin Wang, MD, PhD, of Shandong University, Jinan, China, and colleagues conducted a retrospective study to determine the prognostic and therapeutic value of apolipoprotein A (ApoA), the major protein of high-density lipoprotein, for patients with chronic lymphocytic leukemia (CLL). Their findings, which were published in the journal Frontiers in Oncology, revealed the suppressive effect of ApoA on the proliferation of CLL cells.
“Increased apolipoprotein A was a significant favorable prognostic factor for [patients with CLL]. The apolipoprotein A-I mimetic peptide L-4F exhibited potent therapeutic potential in CLL,” the investigators commented. “The new risk scoring system ARAA score is capable of optimizing the risk stratification of [patients with CLL].”
The ARAA score is based on points assigned for adverse factors such as age of 65 and older (2.5 points), Rai stage III or IV (2.5 points), ApoA level < 0.98 mmol/L (2.5 points), and adenosine deaminase level ≥ 13.55 mmol/L (0.5 point). Patients with higher ARAA scores had worse 5-year progression-free and overall survival than those with lower ARAA scores, the investigators noted.
A total of 150 patients with newly diagnosed CLL were included in the study. The proliferation assay was performed using the human p53-deleted/mutated CLL cell line MEC1 cells, human p53 wide-type CLL cell line EHEB cells, and primary cells from the peripheral blood or bone marrow of four patients.
ApoA appeared to be a favorable independent prognostic factor for overall survival and progression-free survival in patients with CLL. The investigators found ApoA to be negatively associated with β2-microglobulin and advanced-stage disease, which are poor prognostic factors in CLL. Based on cell proliferation assays, the ApoA-I mimetic L-4F seemed to inhibit the proliferation of CLL cell lines and primary cells.
“The use of apolipoprotein A-I in CLL therapy and ARAA score needs further study,” the investigators concluded.
Disclosure: The study authors reported no conflicts of interest.
