p53 in B Cell Chronic Lymphocytic Leukemia (CLL) and Lymphoma with Peripheral Blood Expression along Treatment with Fludarabine and Other Treatment Regimens.

Objective: To determine the expression of mutated p53 at diagnosis, along the treatment and after relapse and correlation itself with rapid disease progression. Mutated p53 was established as marker of disease progression and poor prognosis. Fludarabine is one of the standard treatments for both diseases despite the fact that it promotes p53 gene subset activating apoptosis system.

Patients Materials and method: Forty four patients were enrolled throughout two years. They were studied before, along and after treatment with immunocytochemistry for establishing the frequency of mutated p53 protein. The treatment regimens given were CHOP, one patients with Anaplastic B large cell Lymphoma; CHOP-R (Rituximab tm), one Mantle cell Lymphoma and one B Diffuse Large cell Lymphoma and Cyclophosfamide + Fludarabine oral 20 CLL patient. One patient had a follicular Lymphoma and undergo Autologous Bone Marrow transplantation (ABMT). Other prognosis markers were analyzed, such as p38 and zap 70.

Results: We detected twelve positive cases, two of them CLL both were first negative and then became positive; one spontaneously and the other after second line treatment with fludarabine and relapse. Seven patients with CLL were positive at diagnosis. Three positive p53 patients with Lymphoma, one of them HIV-AIDS the other after ABMT had a rapid progression and promptly died. All the patients with CLL are still alive two of them, the younger patients have a fast duplication of cellular counts and tumor burden.

Conclusion: It is necesary more cases to assert that p53 alone at diagnosis predict bad evolution at least in older patients with CLL who in our experience had a good development, otherwise all the Lymphoma patients and CLL after treatment p53 + had a worts outcome.