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Cytogenetic complexity in chronic lymphocytic leukemia: definitions, associations, and clinical impact
P. Baliakas, S. Jeromin, M. Iskas, A. Puiggros, K. Plevova, F. Nguyen-Khac, Z. Davis, GM. Rigolin, A. Visentin, A. Xochelli, J. Delgado, F. Baran-Marszak, E. Stalika, P. Abrisqueta, K. Durechova, G. Papaioannou, V. Eclache, M. Dimou, T. Iliakis,...
Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články, práce podpořená grantem
Grantová podpora
NV15-30015A
MZ0
CEP - Centrální evidence projektů
NV15-31834A
MZ0
CEP - Centrální evidence projektů
Digitální knihovna NLK
Plný text - Článek
Plný text - Článek
Zdroj
Zdroj
NLK
Free Medical Journals
od 1946 do Před 1 rokem
Freely Accessible Science Journals
od 1946 do Před 1 rokem
Open Access Digital Library
od 1946-01-01
Open Access Digital Library
od 1946-01-01
ROAD: Directory of Open Access Scholarly Resources
- MeSH
- chromozomální aberace * MeSH
- chronická lymfatická leukemie genetika mortalita patologie MeSH
- cytogenetika metody MeSH
- lidé středního věku MeSH
- lidé MeSH
- míra přežití MeSH
- mutace * MeSH
- nádorové biomarkery genetika MeSH
- nádorový supresorový protein p53 genetika MeSH
- následné studie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři MeSH
- somatická hypermutace imunoglobulinových genů genetika MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Recent evidence suggests that complex karyotype (CK) defined by the presence of ≥3 chromosomal aberrations (structural and/or numerical) identified by using chromosome-banding analysis (CBA) may be relevant for treatment decision-making in chronic lymphocytic leukemia (CLL). However, many challenges toward the routine clinical application of CBA remain. In a retrospective study of 5290 patients with available CBA data, we explored both clinicobiological associations and the clinical impact of CK in CLL. We found that patients with ≥5 abnormalities, defined as high-CK, exhibit uniformly dismal clinical outcomes, independently of clinical stage, TP53 aberrations (deletion of chromosome 17p and/or TP53 mutations [TP53abs]), and the expression of somatically hypermutated (M-CLL) or unmutated immunoglobulin heavy variable genes. Thus, they contrasted with CK cases with 3 or 4 aberrations (low-CK and intermediate-CK, respectively) who followed aggressive disease courses only in the presence of TP53abs. At the other end of the spectrum, patients with CK and +12,+19 displayed an exceptionally indolent profile. Building upon CK, TP53abs, and immunoglobulin heavy variable gene somatic hypermutation status, we propose a novel hierarchical model in which patients with high-CK exhibit the worst prognosis, whereas those with mutated CLL lacking CK or TP53abs, as well as CK with +12,+19, show the longest overall survival. Thus, CK should not be axiomatically considered unfavorable in CLL, representing a heterogeneous group with variable clinical behavior. High-CK with ≥5 chromosomal aberrations emerges as prognostically adverse, independent of other biomarkers. Prospective clinical validation is warranted before ultimately incorporating high-CK in risk stratification of CLL.
Department of Haematology Royal Bournemouth Hospital Bournemouth United Kingdom
Department of Hematology University Medical Centre Ljubljana Ljubljana Slovenia
Hematology Department and HCT Unit G Papanicolaou Hospital Thessaloniki Greece
Hematology Department and Sorbonne University Hopital Pitie Salpetriere INSERM U1138 Paris France
Hematology Division Department of Medicine University of Padua Padua Italy
Hematology Section St Anna University Hospital Ferrara Italy
Institute of Applied Biosciences Center for Research and Technology Hellas Thessaloniki Greece
Laboratoire d'hématologie Hopital Avicenne Assistance Publique Hôpitaux de Paris Paris France
MLL Munich Leukemia Laboratory Munich Germany
Servei d'Hematologia Hospital Universitari de la Santa Creu i Sant Pau Barcelona Spain
Servei d'Hematología Hospital Vall d'Hebron Barcelona Spain
Servicio de Genética Citogenética Departamento de Genética Universidad de Navarra Pamplona Spain
Servicio de Hematología Consorcio Hospital General Universitario Valencia Spain
Citace poskytuje Crossref.org
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