Prognostic value of clonal evolution identified by sequential FISH in untreated chronic lymphocytic leukaemia

IF 1.4 Q4 ONCOLOGY
R. Dondolin, Matteo Bellia, S. Rasi, C. Deambrogi, D. Talotta, S. Mouhssine, Wael Al Essa, A. Mahmoud, Danilo Faraci, G. Gaidano, R. Moia
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引用次数: 0

Abstract

Aim: The aim of the current study was to evaluate the potential clinical impact of clonal evolution detected by fluorescence in situ hybridization (FISH) in untreated chronic lymphocytic leukaemia (CLL) patients managed with a watch-and-wait strategy. Methods: We performed both overall survival (OS) and time to first treatment (TTFT) analysis. For the first one, we exploited a real-life cohort of 123 consecutive CLL patients followed at our institution, for which at least a second FISH evaluation during watch and wait was available. For TTFT analysis, we considered only patients treated after the second FISH sample (n = 69). Results: Considering the original cohort, patients who acquired a FISH abnormality displayed a worse outcome with a median OS of 91.9 months compared to 147.3 months for patients who did not acquire any FISH abnormalities (P = 0.007). Unmutated immunoglobulin heavy chain gene (IGHV) genes were associated with a higher probability of acquiring a FISH abnormality (P = 0.04). Turning to TTFT analysis, patients who gained at least one FISH abnormality (n = 7, 10%) were characterised by an earlier treatment requirement with a median TTFT of 1.1 months, compared to 2.7 months in patients who did not acquire any FISH abnormalities (n = 62, 90%) (P = 0.025). Conclusions: The dynamic acquisition of karyotypic abnormalities by FISH predicts poor outcomes and early treatment requirement in CLL patients. Our results suggest that FISH analysis could be integrated with other clinical and biological features to obtain dynamic scores that are able to predict outcomes at different phases of disease history.
在未经治疗的慢性淋巴细胞白血病中,通过连续 FISH 鉴定出的克隆进化具有预后价值
目的:本研究旨在评估通过荧光原位杂交(FISH)检测到的克隆进化对采用观察和等待策略管理的未治疗慢性淋巴细胞白血病(CLL)患者的潜在临床影响。方法我们进行了总生存期(OS)和首次治疗时间(TTFT)分析。对于前者,我们利用了本机构连续跟踪的 123 例 CLL 患者的真实队列,这些患者在观察和等待期间至少进行了第二次 FISH 评估。在 TTFT 分析中,我们只考虑了在第二次 FISH 样本之后接受治疗的患者(n = 69)。结果考虑到原始队列,出现 FISH 异常的患者预后较差,中位 OS 为 91.9 个月,而未出现任何 FISH 异常的患者为 147.3 个月(P = 0.007)。未突变的免疫球蛋白重链基因(IGHV)与较高的 FISH 异常概率相关(P = 0.04)。转到 TTFT 分析,获得至少一个 FISH 异常的患者(n = 7,10%)需要更早的治疗,中位 TTFT 为 1.1 个月,而未获得任何 FISH 异常的患者(n = 62,90%)为 2.7 个月(P = 0.025)。结论通过 FISH 动态获得核型异常可预测 CLL 患者的不良预后和早期治疗需求。我们的研究结果表明,FISH 分析可与其他临床和生物学特征相结合,获得动态评分,从而预测不同病史阶段的预后。
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来源期刊
CiteScore
3.20
自引率
5.30%
发文量
460
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