Table 1.
Characteristics of the CLL Patients (n = 110)a.
Fig 1.
The TL and STL% of CLL patients.
(A) The mean telomere lengths (TLs) were compared between CLL patients and bone marrow (BM) from normal controls. The CLL patients’ TLs were shorter than those in the normal BM samples with age adjustment (7.46 (range 1.19–18.14) in CLL patients; 15.28 (range 8.59–24.93) in normal BM control samples, median value). (B) The STL% was compared between the CLL patient group and normal BM control group. CLL patients had a higher STL% than the control group (52.95 (± 31.33) in the CLL group and 10.20 (± 9.65) in the normal control group). *** indicates p < 0.001 for comparison.
Fig 2.
The TL distribution of CLL patients’ analyzed cells.
The TLs of analyzed cells from CLL patients (n = 71) and the normal control percentiles are presented in the dot plot and bar. The TLs of CLL cells were generally biased to the lower percentile of the normal control group. Cells with TLs shorter than 7.61, the length of the 10th percentile of a normal TL, accounted for 54.8% of CLL cells, and cells with a TL shorter than 11.96, the length of the 30th percentile of a normal TL, accounted for 73.6% of CLL cells. CLL patients’ cells with a TL longer than 40.00 (T/C ratio) are not shown in this graph (n = 4, range 44.59–56.70).
Fig 3.
Correlation analysis of TL, the STL%, and clinical parameters.
The graph shows that Hb had statistically significant correlations with TL (Tb = 0.188, p = 0.021) and the STL% (Tb = -0.207, p = 0.013). Significant correlations are marked as bold boxes. * Abbreviations: WBC, white blood cell; Hb, hemoglobin; BM, bone marrow.
Fig 4.
Comparison of TL and the STL% among the Binet stages.
A worse Binet stage corresponds to a shorter TL (stage A = 8.91, B = 8.21, C = 7.12, mean values) and a greater STL% (stage A = 47.5, B = 51.4, C = 65.9, mean value). However, no statistically significant differences were found among Binet stages (p = 0.156 for TLs, p = 0.173 for the STL%).
Fig 5.
Kaplan-Meier survival curves of TL and the STL%.
The overall survival rates changed at a TL of 9.35 and an STL% of 90%.
Table 2.
Comparison of telomere lengths according to cytogenetic abnormality or gene mutation.
Table 3.
Univariable and multivariable cox analyses of overall survival among CLL patientsa.
Fig 6.
Survival Analysis of the risk equation model compared to Binet stage.
(A) In the Kaplan-Meier (K-M) curve, the Binet stage did not show survival differences, and the survival graphs overlapped each other. (B) The risk groups stratified by the risk factor equation of Korean CLL patients showed better K-M survival curves than those stratified by the Binet stage. The risk equation model was complex karyotype × 2.46 + TP53 mutation × 1.49 + total mutated gene number × 0.61. The low-, intermediate-, and high-risk groups were divided by a risk equation score of 1.83 or less, 1.83 to 3.08, and greater than 3.08, respectively. Harrell’s C-index of risk groups assessed by the risk equation (0.748) was also higher than that of groups stratified by Binet stage (0.624).