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The University of Southampton
Medicine

Predicting the progression of chronic leukaemia

Research by the University of Southampton has helped transform treatment of a common leukaemia affecting thousands each year. Our studies have been crucial in giving clinicians and patients a clear indication of the likely disease course. Additionally our chronic lymphocytic leukaemia (CLL) predictor is now included in all clinical trials and international guidelines for delivering improved care.

Research Challenge

CLL is the most prevalent form of leukaemia in the Western World. It tends to occur in later life and is more widespread in men than in women. Every year around 17,000 people in the US and 2,400 in the UK are diagnosed with the disease but prognosis varies greatly between patients and life expectancy is difficult to predict.

Context

Before our researchers uncovered a major prognostic marker, CLL was considered to be a single disease with a variable and unpredictable clinical course. Our studies showed there are actually two subsets of CLL with significantly different progression rates, requirement for treatment and overall survival. Previous research worldwide had missed this subdivision due the inability to reveal the two subsets by cell morphology and phenotype.

Our Solution

Our academic team employed sequencing techniques involving the analysis of human immunoglobulin genes expressed by CLL cancers. This led to the major insight that these haematological malignancies could be subdivided into two subsets.

It was discovered that 40% of patients had a more aggressive disease, with a short survival rate, and 60% had a less aggressive variant with a 25 year life expectancy. These findings have since been confirmed by multiple studies and widely accepted.

The Impact

Our research has had far-reaching implications for patients, their families and clinicians. Patients can now be given a more accurate prognosis whilst clinicians are able to offer better directed and therefore improved cancer care.

Better prognosis means chemotherapy can be avoided or delayed for some patients bringing both economic savings and benefits to patients' well-being. In contrast, new drug therapy can be targeted earlier toward patients with a poorer prognosis.  These factors were the driving force behind international guidelines for diagnosis and treatment. 

Our findings have also had a dramatic effect on the understanding of pathogenesis and clinical management.  Immunoglobulin gene analysis is now mandatory for cases of CLL entering clinical trials.

Southampton shows that the prognosis of CLL treatment can be predicted by immunoglobulin gene expression analysis
Improved CLL treatment

Key Publications

List of all staff members in
Staff MemberPrimary Position
Freda StevensonProfessor of Immunology
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