Increased Serum Von Willebrand Levels in Chronic Lymphocytic Leukemia (CLL) Patients Are Related To a Shorter Time to Treatment - Abstract
Chronic lymphocytic leukemia (CLL) is the most frequent leukemia of elderly patients and the role of angiogenesis in CLL pathogenesis and prognosis remains unclear. Angiogenesis may be evaluated by indirect methods such as evaluating von Willebrand factor (vWF) stainig by immunohistochemistry. Here we investigated whether serum vWF levels in CLL patients at diagnosis are related to disease characteristics or prognosis. Seventy-two (72) CLL patients were studied of whom 52%, 32% and 16% were Binet staged A, B and C respectively. Serum vWF was measured by ELISA (R&D Quantiquine, duo Set) in frozen sera drawn at patients’ diagnosis and in 10 healthy individuals (HI). Forty-three percent never required treatment while 55% required treatment either at the time of diagnosis or during their follow-up. None of the patients presented hemorrhage or thrombosis. Statistical analysis was performed by conventional methods, using the SPSS v.22 software. behavior. Serum vWF levels ranged from undetectable (0) to 17998 pg/ml (median 4273,8) in patients and from 374,6 to 4422,5 pg/ml (median 2692,7) in HI, the difference being statistically significant (p< 0,05). Patients with serum vWF levels above patients median had a significantly shorter Time to First treatment than the others (p=0,000054). Otherwise, serum vWF levels correlated only with hypogammaglobulinemia (p=0,04). Our results suggest for the first time, to our knowledge, that serum vWF levels are increased in CLL patients and importantly, that higher vWF levels correlated with a shorter TFT, suggesting that increased vWF levels reflect active neoangiogenesis that in turn, contributes to a more aggressive disease