Abstract:
Novel drugs have profoundly changed the outcomes in chronic lymphocytic leukemia (CLL) patients, and the traditional prognostic factors that were identified in the era of chemoimmunotherapy need to be validated in the context of these new targeted therapies. Currently, the most important prognostic genetic biomarkers are the immunoglobulin heavy chain variable (IGHV) mutational status, genetic aberrations including del(17p)/TP53 abnormalities, and the complex karyotype. In this review, we discuss the prognostic role of these genomic markers in relation to novel treatments. Moreover, we present and discuss new scoring systems that were elaborated and validated in the era of new drugs. In routine clinical practice, the application of an extensive genomic work-up with validated prognostic markers could improve the identification of \"very high-risk\" CLL patients who could benefit from novel, more effective targeted treatments.
摘要:
新型药物深刻地改变了慢性淋巴细胞白血病(CLL)患者的预后,而在化学免疫疗法时代确定的传统预后因素需要在这些新的靶向疗法的背景下进行验证.目前,最重要的预后遗传生物标志物是免疫球蛋白重链可变(IGHV)突变状态,遗传畸变,包括del(17p)/TP53异常,和复杂的核型。在这次审查中,我们讨论了这些基因组标记与新疗法相关的预后作用。此外,我们提出并讨论了在新药时代得到完善和验证的新评分系统.在常规临床实践中,使用经过验证的预后标志物进行广泛的基因组检查可以提高对“非常高风险”CLL患者的识别,这些患者可以从新的疾病中受益,更有效的靶向治疗。