Chronic lymphocytic leukemia prognosis and treatment

Abstract

Provided herein are methods for identifying a subject afflicted with chronic lymphocytic leukemia who is responsive to treatment with a chemotherapeutic agent by detecting the presence or absence of at least one APOE4 allele in the subject, the presence of an APOE4 allele identifying the subject as responsive to the treatment. Also provided are methods of treating a subject afflicted with chronic lymphocytic leukemia, including administering an estrogenic agent, an androgen withdrawal agent, an apoE4 peptide or mimetic thereof, and/or a chemotherapeutic agent in an amount effective to treat said chronic lymphocytic leukemia. Methods of determining a prognosis for a patient diagnosed with chronic lymphocytic leukemia are also provided. In addition, methods for stratifying a subject into a subgroup of a clinical trial and methods for identifying a patient in a clinical trial of a treatment for chronic lymphocytic leukemia are herein provided.

That which is claimed is: 
     
         1 . A method of treating a subject afflicted with chronic lymphocytic leukemia comprising administering to said subject apoE4 or a mimetic thereof in an amount effective to treat said chronic lymphocytic leukemia. 
     
     
         2 . The method of  claim 1 , wherein said administering step is carried out by administering to said subject VLDL-apoE4. 
     
     
         3 . The method of  claim 1 , further comprising the step of detecting the presence or absence of an APOE4 allele in a biological sample of said subject. 
     
     
         4 . The method of  claim 3 , wherein said detecting step is carried out by genotyping. 
     
     
         5 . The method of  claim 1 , wherein said administering step is carried out by oral administration. 
     
     
         6 . The method of  claim 1 , wherein said administering step is carried out by parenteral administration. 
     
     
         7 . A method of treating a subject afflicted with chronic lymphocytic leukemia comprising administering to said subject apoE4 or a mimetic thereof in combination with administering to said subject an estrogenic agent or androgen withdrawal agent, the two combined in an amount effective to treat said chronic lymphocytic leukemia. 
     
     
         8 . The method of  claim 7 , wherein said administration step is carried out by administering to said subject VLDL-apoE4 in combination with administering to said subject an estrogenic agent or androgen withdrawal agent.