Rossi et al identified 4 prognostic subgroups in chronic lymphocytic leukemia (CLL) based on mutational and cytogenetic findings. These can help to identify a patient who may or who may not benefit from more aggressive management. The authors are from multiple institutions in Italy, Spain and the United States.
Patient selection: CLL
Mutations/Cytogenetics
Risk
10-year Survival
TP53 and/or BIRC3
high
29%
NOTCH1 and/or SF3B1 and/or del 11q22-q23
intermediate-high
37%
+12 or normal genetics
low
57%
del 13q14 only
very low
69%
Additional factors from multivariate analysis associated with worse overall survival (Table 1):
(1) older age
(2) Rai stage III or IV
(3) IGHV homology > 98% (unmutated)
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