Increased serum levels of vascular endothelial growth factor predict risk of progression in early B-cell chronic lymphocytic leukaemia

The present study is the first to evaluate serum levels of vascular endothe lial growth factor (VEGF) in B-cell chronic lymphocytic leukaemia (CLL). Al l 68 B-cell CLL patients and 31 control subjects analysed had detectable se rum levels of VEGF, with no statistically significant difference between tw o proups. An aberrant increase of circulating levels of VEGF was found in o nly 17.6% of cases. B-cell CLL patients whose serum VEGF levels were higher than the median (i.e. 194.8 pg/ml) or 75th percentile (i.e. 288.5 pg/ml) v alues were more frequently at an advanced clinical stage. In contrast, no c orrelation with other clinico-biological features representative of either tumour mass [bone marrow (BM) histology, peripheral blood (PB) lymphocytosi s, beta-2 microglobulin (beta-2m). LDH, interleukin-6 (IL-6)] or disease-pr ogression (DP) [lymphocyte doubling time (LDT)] was found. Serum levels of VEGF predicted the risk of DP in early CLL. Among 41 patien ts in Binet stage A, progression-free survival (PFS) was significantly shor ter in those patients whose VEGF serum concentrations were above the median value. Interestingly, characteristics of stage A patients stratified accor ding to the median value of VEGF were similar with respect to many clinico- biological features, thus suggesting a possible independent prognostic role for such a marker. Finally, when added to the Rai subclassification, VEGF serum levels identified two groups with different PFS within stages I-II. We conclude that increased serum levels of VEGF can be considered useful fo r predicting the risk of DP and add prognostic information to the Rai subcl assification of stage A CLL.