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April 16, 2026Cancer Medicine0 citationsOpen Access

Adverse Effects of Low Serum HDL ‐C Levels on Prognosis and Tumor Immune Microenvironment in Patients With Newly Diagnosed Chronic Lymphocytic Leukemia

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WLWeiran LVSLShutong LiuJSJuan Song

Key Result

Low serum HDL-C levels were associated with poor overall survival and progression-free survival in patients with newly diagnosed chronic lymphocytic leukemia.

Key Points

  • This research aims to explore the connection between serum HDL-C levels and prognosis in patients newly diagnosed with chronic lymphocytic leukemia.
  • Retrospective data analysis of 142 newly diagnosed CLL patients.
  • Survival analysis assessed the relationship between HDL-C levels and overall survival.
  • Multivariate analysis determined HDL-C as an independent prognostic factor.
  • Validation performed with 448 CLL patients and flow cytometry analysis of lymphocyte subpopulations.
  • Low HDL-C levels correlate with reduced overall survival and progression-free survival in CLL patients.
  • HDL-C serves as an independent hazard element for overall survival.
  • A nomogram combining HDL-C and classical factors improves 5-year survival predictions.
  • Positive correlation between HDL-C and the presence of natural killer cells is observed.
  • In vitro experiments showed HDL enhances NK cell cytotoxicity.

Study Design

Type

Cohort (n=142)

Structured PICO

Are low serum HDL-C levels associated with poor prognosis in patients with newly diagnosed chronic lymphocytic leukemia?

P
Population
142 patients with newly diagnosed chronic lymphocytic leukemia (ND-CLL) in a retrospective cohort, with an external validation cohort of 448 CLL patients, and 194 for flow cytometry analysis.
I
Intervention
Low serum HDL-C/ApoA1 levels
O
Outcome
Overall survival (OS) and progression-free survivalhard clinical

Low serum HDL-C levels are associated with poor prognosis in newly diagnosed CLL, potentially mediated by impaired NK cell cytotoxicity.

Abstract

ABSTRACT Disorders of lipid metabolism contribute to the occurrence and progression of hematological malignancies, including chronic lymp hocytic leukemia (CLL). The objective of this study was to investigate the association between serum lipid levels and prognosis in patients with CLL. We retrospectively analyzed data from 142 patients with newly diagnosed CLL (ND‐CLL). Our survival analysis showed that low levels of high‐density lipoprotein cholesterol/Apolipoprotein‐A1 (HDL‐C/ApoA1) were associated with poor overall survival (OS) and progression‐free survival in patients with ND‐CLL. Multivariate analysis identified HDL‐C as an independent hazard element for OS. A nomogram combining HDL‐C levels and classical prognostic factors increased the accuracy of predicting 5‐year OS compared to prediction based solely on classical prognostic factors. The adverse effect of low levels of HDL‐C on prognosis in CLL patients was further validated through external validation, wherein the functionality of HDL‐C was simulated by assessing cholesterol efflux in a cohort comprising 448 CLL patients. Moreover, flow cytometry analysis of 194 peripheral blood lymphocyte subpopulations demonstrated that the levels of HDL‐C/ApoA1 was significantly positively correlated with natnatural killer (NK) cells. Subsequent in vitro cell experiments confirmed the ability of HDL to augment NK cell cytotoxicity, as evidenced by elevated expression levels of CD107a and tumor necrosis factor‐α. In conclusion, low serum HDL‐C levels are related to a poor prognosis in patients with ND‐CLL, potentially due to impaired NK cell cytotoxicity, providing insight into the prognostic role of HDL‐C and proposing a new potential therapeutic target in patients with ND‐CLL.

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Cite This Study

LV et al. (2026) conducted a cohort in newly diagnosed chronic lymphocytic leukemia (ND-CLL) (n=142). Low serum HDL-C levels was evaluated on overall survival (OS) and progression-free survival. Low serum HDL-C levels were associated with poor overall survival and progression-free survival in patients with newly diagnosed chronic lymphocytic leukemia.

synapsesocial.com/papers/69e07e582f7e8953b7cbf61ahttps://doi.org/10.1002/cam4.71791
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