title: Controversial fluorescence in situ hybridization cytogenetic abnormalities in chronic lymphocytic leukaemia: new insights from a large cohort.
abstract: The significance of rarer cytogenetic abnormalities in chronic lymphocytic leukaemia (CLL) remains controversial. We performed fluorescence in situ hybridization (FISH) prior to initial therapy on 618 CLL patients seen at our centre between 2005 and 2012. With a median follow-up of 5·6 years, we found that 55 patients harbouring 14q32 rearrangements without t(14;18) had a shorter time to first treatment (TTFT) (median 26 months, P = 0·03) than patients with t(14;18) (median not reached). Patients with mono- or bi-allelic del(13q) as a sole abnormality had a similarly long TTFT (median not reached). Those patients who harboured 3 or more FISH abnormalities without del(17p) had a short TTFT (4·6 months), comparable to patients with del(17p) (8 months); however, the overall survival for patients with 3 or more FISH abnormalities was longer than for patients with del(17p) with 0 or 1 additional abnormalities (median not reached vs. 54 months). FISH cytogenetics remains a useful genetic tool in the clinic, even in the era of next generation sequencing and, as such, our data provide valuable new insights for counselling patients.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Matthew S
authors.initials: MS
authors.lastname: Davids
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Alexander
authors.initials: A
authors.lastname: Vartanov
authors.affiliation: Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Lillian
authors.initials: L
authors.lastname: Werner
authors.affiliation: Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA, USA.
authors.forename: Donna
authors.initials: D
authors.lastname: Neuberg
authors.affiliation: Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA.
authors.forename: Paola
authors.initials: P
authors.lastname: Dal Cin
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Brown
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D002877:Chromosomes, Human / Q000235:genetics*; D005260:Female; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
keywords: IgH; chronic lymphocytic leukaemia; cytogenetics of leukaemia; fluorescence in situ hybridization; prognostic factors