Details

Autor(en) / Beteiligte

• Galieni, Piero
• Troiani, Emanuela
• Picardi, Paola
• Angelini, Mario
• Mestichelli, Francesca
• Dalsass, Alessia
• Maravalle, Denise
• Camaioni, Elisa
• Bigazzi, Catia
• Caraffa, Patrizia
• Ruggieri, Miriana
• Mazzotta, Serena
• Mattioli, Silvia
• Angelini, Stefano

Titel

Unmutated IGHV at diagnosis in patients with early stage CLL independently predicts for shorter follow-up time to first treatment (TTFT)

Ist Teil von

• Leukemia research, 2024-08, Vol.143, p.107541, Article 107541

Ort / Verlag

Elsevier Ltd

Erscheinungsjahr

2024

Quelle

ScienceDirect

Beschreibungen/Notizen

• The mutational status of the IGHV gene is routinely assessed in patients with chronic lymphocytic leukaemia (CLL), since it is both prognostic of clinical outcome and predictive of response to treatment. This study evaluates the IGHV mutational status, assessed in newly diagnosed CLL patients, as a stand-alone predictor of time to first treatment (TTFT). We analysed the data of 236 CLL patients, diagnosed at our centre between January 2004 and September 2020, with a minimum follow-up period of 3.0 years, Binet A-B and Rai 0-II stages. IGHV was unmutated in 38.1 % and mutated in 61.9 % of cases. The univariate analysis showed a statistically significant difference (p < 0.001) in TTFT based on unmutated (85.2 % at 14 years, 95 % CI = 63.3–94.5 %) or mutated (41.3 % at 14 years, 95 % CI = 29.5–51.8 %) and the need for treatment at 1, 3 and 5 years was of 20.0 % vs 4.1 % (p < 0.001), 42.7 % vs 11.4 % (p < 0.001) and 55.8 % vs 20.0 % (p < 0.001) in unmutated and mutated IGHV patients, respectively. Multivariate analysis confirmed that unmutated IGHV status negatively affects TTFT (p < 0.001), in addition to high-risk genomic aberration (p = 0.025), Rai stage I (p = 0.007) and II (p-value < 0.001). The difference in TTFT based on unmutated or mutated IGHV status remains statistically significant also when considering the subgroups by the genomic aberrations and Rai stages. Our findings suggest that, with the single analysis of the IGHV mutational status at CLL diagnosis, along with clinical and laboratory data, and without karyotype and TP53 data, clinicians will have prognostic and predictive indications for the first clinical treatment and appropriate follow-up of patients. •In patients diagnosed with chronic lymphocytic leukaemia, the assessment of the IGHV mutational status is routinely performed in clinical practice.•Recent studies have also identified the IGHV mutational status as a parameter that, when associated with other different variables, is able to determine the time from diagnosis to initial treatment.•IGHV mutational status as a stand-alone parameter to predict the time to first treatment in patient with CLL.