Characterizing patients with multiple chromosomal aberrations detected by FISH in chronic lymphocytic leukemia

Abstract

We analyzed the features of chronic lymphocytic leukemia (CLL) with multiple abnormalities (MA) detected by FISH. A local database including 2095 CLL cases was used and 323 with MA (15.4%) were selected. MA was defined by the presence of two or more alterations (deletions of 13q14 (13q-), 11q22 (11q-), 17p13 (17p-) or trisomy 12 (+12)). The combination of 13q- with 11q- and 13q- with 17p-, accounted for 58.2% of the series, in contrast to 11q- with 17p- (3.7%). Patients carrying MA since diagnosis presented a short time to first therapy(TTFT) (27 months) and overall survival (OS) (76 months). The combinations including 17p- had a shorter OS (58 months) than the ones without 17p- (not reached, p = .002). Patients with a complex-FISH were the ones with worse OS (34 months). MA imply poor prognosis when they emerge at diagnosis, probably due to the high incidence of bad prognosis markers, which may be a reflection of a more complex karyotype.

Small Non-Coding RNAs in Leukemia

“…At that time, deletions of the 11q region were known to target the ATM gene [70,71], while deletions of the 17p region were known to encompass the p53 gene [72,73]. These aberrations, often found in association with the deletion of 13q, were recognized predictors of aggressive disease [74]. However, as opposed to the 11q and 17p abnormalities, the 13q deletion did not seem to affect a coding gene.…”

The Evolving Landscape of Chronic Lymphocytic Leukemia on Diagnosis, Prognosis and Treatment

“…However, these studies have been inconclusive with respect to the value of such higher resolution approaches for the risk assessment in CLL. Thanks to the introduction of modern cell stimulation protocols, conventional CBA has recovered its prognostic relevance in the last years, since recent reports have shown that complex karyotype contributes to an adverse outcome [ 91 , 92 , 93 , 94 ]. It has been described as a prognostic marker for refractoriness not only during chemoimmunotherapy [ 15 , 95 , 96 ] but, also, to TA [ 97 , 98 ].…”