CLL Coverage from Every Angle

Serum APRIL Levels: Novel Prognostic Marker Under Study in CLL

By: Vanessa A. Carter, BS
Posted: Friday, April 23, 2021

Measuring serum levels of a proliferation-inducing ligand known as APRIL may prove to be a useful prognostic marker in chronic lymphocytic leukemia (CLL). Sinem Nihal Esato─člu, MD, of Istanbul University-Cerrahpa┼ča, Turkey, and colleagues conducted a study to identify the time-to-treatment cutoff serum levels of this marker in patients who are treatment-naive. Published in the Turkish Journal of Medical Sciences, these study findings suggested that a serum level of APRIL of 2.04 ng/mL was the best predictor but emphasized that further research is necessary.

The researchers collected venous blood samples from 94 individuals with CLL and 25 healthy controls. Patients with leukemia were divided into three groups: those who received prior chemotherapy (n = 22), those currently receiving chemotherapy (n = 25), and those who have not received treatment (n = 47). Serum levels of APRIL were calculated using enzyme-linked immunosorbent assay; demographic data. Other prognostic markers were obtained from participant medical records.

Median serum levels of APRIL were significantly higher in patients with cancer than in healthy participants (2.63 ng/mL vs. 1.29 ng/mL); participants who were treatment-naive (2.78 ng/mL) and who received prior chemotherapy (3.54 ng/mL) demonstrated the highest levels of this marker. Additionally, median levels of patients who were currently receiving chemotherapy (1.56 ng/mL) did not seem to differ from those of controls, suggesting that serum levels of APRIL may be influenced by treatment.

In terms of prognostic effectiveness, the best cutoff of this serum marker was 2.04 ng/mL. Treatment-naive patients were further divided into two groups: high level (n = 27) and low level (n = 20). In the high-level group, 18 of 27 patients required chemotherapy during follow-up; 5 of 20 patients in the low-level group received treatment. Ultimately, time to treatment was significantly earlier in the high-level group than the low-level group (P = .010 vs .003), further supporting the proposed cutoff level.

Disclosure: The study authors reported no conflicts of interest.

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