Autor/a:
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Baliakas, Panagiotis; Moysiadis, Theodoros; Hadzidimitriou, Anastasia; Xochelli, Aliki; Jeromin, Sabine; Agathangelidis, Andreas; Mattsson, Mattias; Sutton, Lesley-Ann; Minga, Eva; Scarfò, Lydia; Rossi, Davide; Davis, Zadie; Villamor i Casas, Neus; Parker, Helen; Kotaskova, Jana; Stalika, Evangelia; Plevova, Karla; Mansouri, Larry; Cortese, Diego; Navarro López, Alba; Delgado, Julio (Delgado González); Larrayoz, Marta; Young, Emma; Anagnostopoulos, Achilles; Smedby, Karin E.; Juliusson, Gunnar; Sheehy, Oonagh; Catherwood, Mark; Strefford, Jonathan C.; Stavroyianni, Niki; Belessi, Chrysoula; Pospisilova, Sarka; Oscier, David; Gaidano, Gianluca; Campo Güerri, Elias; Haferlach, Claudia; Ghia, Paolo; Rosenquist, Richard; Stamatopoulos, Kostas
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Abstract:
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Chronic lymphocytic leukemia (CLL) patients with differentialsomatic hypermutation status of the immunoglobulin heavy vari-able genes, namely mutated or unmutated, display fundamentalclinico-biological differences. Considering this, we assessed prognosisseparately within mutated (M-CLL) and unmutated (U-CLL) CLL in 3015patients, hypothesizing that the relative significance of relevant indica-tors may differ between these two categories. Within Binet A M-CLLpatients, besides TP53abnormalities, trisomy 12 and stereotyped subset#2 membership were equivalently associated with the shortest time-to-first-treatment and a treatment probability at five and ten years afterdiagnosis of 40% and 55%, respectively; the remaining cases exhibited5-year and 10-year treatment probability of 12% and 25%, respectively.Within Binet A U-CLL patients, besides TP53abnormalities, del(11q)and/or SF3B1mutations were associated with the shortest time-to-first-treatment (5- and 10-year treatment probability: 78% and 98%, respec-tively); in the remaining cases, males had a significantly worse prognosisthan females. In conclusion, the relative weight of indicators that canaccurately risk stratify early-stage CLL patients differs depending on thesomatic hypermutation status of the immunoglobulin heavy variablegenes of each patient. This finding highlights the fact that compartmen-talized approaches based on immunogenetic features are necessary torefine and tailor prognostication in CLL. |