title: The importance of IGHV mutational status in del(11q) and del(17p) chronic lymphocytic leukemia.
abstract: Most patients with CLL with a poor-risk cytogenetic profile have an unmutated IGHV sequence. Limited clinical information exists for patients with CLL who have a poor-risk cytogenetic profile and a mutated or good-risk IGHV status. We retrospectively screened all patients with CLL seen at our institution from 2006 onward who harbored a del(11q) or del(17p) CLL detected by fluorescence in situ hybridization (FISH) analysis for whom an IGHV analysis was requested. In 66 evaluable patients, 50 (76%) had an unmutated IGHV sequence. Thirty-nine patients (59%) had del(11q) and 27 patients (41%) had del(17p); no patient in this series had both del(11q) and del(17p). The patients' initial clinical presentations were similar in both mutational groups. Patients with an unmutated IGHV sequence were more likely to receive treatment and to have a shorter survival, with an estimated 3-year overall survival (OS) of 81% compared with 100% in the group with a mutated IGHV sequence (log rank, P = .06). These data suggest that IGHV mutational status has prognostic relevance even in patients with CLL who are defined as poor risk by genomic FISH analysis.
authors.affiliation: The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD 21287, USA. dgladst1@jhmi.edu
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Gladstone
authors.forename: Amanda
authors.initials: A
authors.lastname: Blackford
authors.forename: Eunpi
authors.initials: E
authors.lastname: Cho
authors.forename: Lode
authors.initials: L
authors.lastname: Swinnen
authors.forename: Yvette
authors.initials: Y
authors.lastname: Kasamon
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Gocke
authors.forename: Constance A
authors.initials: CA
authors.lastname: Griffin
authors.forename: Javier
authors.initials: J
authors.lastname: Bolaños-Meade
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D002872:Chromosome Deletion; D002880:Chromosomes, Human, Pair 11; D002886:Chromosomes, Human, Pair 17; D005500:Follow-Up Studies; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics*; D007135:Immunoglobulin Variable Region / Q000235:genetics; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics* / Q000401:mortality* / Q000628:therapy; D008875:Middle Aged; D009154:Mutation; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D000970:Antineoplastic Agents; D007143:Immunoglobulin Heavy Chains; D007135:Immunoglobulin Variable Region