title: ESMO consensus conference on malignant lymphoma: general perspectives and recommendations for prognostic tools in mature B-cell lymphomas and chronic lymphocytic leukaemia.
abstract: The European Society for Medical Oncology (ESMO) consensus conference on mature B-cell lymphomas and chronic lymphocytic leukaemia (CLL) was held on 20 June 2015 in Lugano, Switzerland, and included a multidisciplinary panel of 25 leading experts. The aim of the conference was to develop recommendations on critical subjects difficult to consider in detail in the ESMO Clinical Practice Guidelines. The following areas were identified: (i) the elderly patient, (ii) prognostic factors suitable for clinical use and (iii) the 'ultra-high-risk' group. Before the conference, the expert panel was divided into three working groups; each group focused on one of these areas in order to address four clinically relevant questions relating to that topic. All relevant scientific literature, as identified by the experts, was reviewed in advance. During the consensus conference, each working group developed recommendations to address each of the four questions assigned to their group. These recommendations were then presented to the entire panel and a consensus was reached. This manuscript presents recommendations dedicated to the second area of interest, i.e. prognostic factors suitable for clinical use. The four topics [i.e. interim positron emission tomography (PET), TP53 mutations, cell of origin (COO) and minimal residual disease (MRD)] were primarily chosen because of the bulk of available data together with the lack of clear guidance regarding their use in clinical practice and within clinical trials. Results, including a summary of evidence supporting each recommendation, are detailed in this manuscript. The panel acknowledged that detection of TP53 inactivation by deletion or mutation in CLL should be implemented in clinical practice (level of evidence I, strength of recommendation A). Due to their potentially high prognostic value, at least in some lymphoma entities, implementation of interim PET, COO and MRD was highly recommended in the context of clinical trials. All expert panel members approved this final article.
authors.affiliation: Hematology Division, Azienda Ospedaliera Santi Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Ladetto
authors.affiliation: Comprehensive Cancer Center Ulm and Department of Internal Medicine III, Institute of Experimental Cancer Research, University Hospital, Ulm, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Buske
authors.affiliation: Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Hutchings
authors.affiliation: Medizinische Klinik III, Klinikum der Universität München/LMU, Munich, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Dreyling
authors.affiliation: Division of Hematology, Department of Translational Medicine, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Gaidano
authors.affiliation: Clinical Hematology, Centre Hospitalo-Universitaire de Nantes, UMR892 Team 10, CIC Nantes, France.
authors.forename: S
authors.initials: S
authors.lastname: Le Gouill
authors.affiliation: Hematology, Arcispedale S. Maria Nuova, IRCCS Reggio Emilia.|Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Luminari
authors.affiliation: Second Medical Department, University Hospital Schleswig-Holstein, Kiel, Germany.
authors.forename: C
authors.initials: C
authors.lastname: Pott
authors.affiliation: Department of Diagnostics and Public Health, University of Verona, Verona, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Zamò
authors.affiliation: Lymphoma Unit, Oncology Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
authors.forename: E
authors.initials: E
authors.lastname: Zucca
mesh_terms: D000368:Aged; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000453:epidemiology / Q000473:pathology*; D008223:Lymphoma / Q000453:epidemiology / Q000473:pathology*; D016393:Lymphoma, B-Cell / Q000453:epidemiology / Q000473:pathology*; D008495:Medical Oncology; D011379:Prognosis; D012307:Risk Factors; D012955:Societies, Medical; D013557:Switzerland
keywords: TP53; cell of origin; consensus; lymphoma; minimal residual disease; positron emission tomography