Complex karyotype as a predictor of high-risk chronic lymphocytic leukemia: A single center experience over 12 years. (October 2019)

• Record Type: Journal Article
• Authors: Kruzova, Lenka; Schneiderova, Petra; Holzerova, Milena; Vatolikova, Michaela; Divoka, Martina; Turcsanyi, Peter; Urbanova, Renata; Kudelka, Milos; Radvansky, Martin; Kriegova, Eva; Papajik, Tomas; Urbankova, Helena
• Is Part Of: Leukemia research. Volume 85(2019)
• Publication Date: 2019-10
• Subjects: Chronic lymphocytic leukemia (CLL) -- Complex karyotype -- Cytogenetics -- TP53 -- ATM; Leukemia -- Periodicals; Leukemia -- Periodicals; Leucémie -- Périodiques; Leukemia; Periodicals; Electronic journals; Electronic journals; 616.9941905
• DOI: 10.1016/j.leukres.2019.106218
• Languages: English
• ISSNs: 0145-2126

Abstract

Highlights: Complex karyotype affects clinical and treatment decision-making in the diagnosis of chronic lymphocytic leukemia. Complex karyotype is a marker of poor prognosis and short overal survival. Complex karyotype has adverse prognosis with or without aberrations of TP53 and ATM . Abstract: Objectives: A complex karyotype (CK) is considered a poor prognostic marker in chronic lymphocytic leukemia (CLL). Methods: The study analyzed 644 untreated CLL patients (pts) using conventional/molecular cytogenetics to reveal the presence of a CK and its composition and to assess its predictive value. The mutational status of TP53 was detected by next generation sequencing. Results: A CK was detected in 79 pts (12.3%). Patients with a CK showed shorter overall survival (OS) compared to those without a CK (77 months vs. 115 months, p < 0.0001). Chromosomes most frequently included in a CK were 13, 11, 17, 8, 2, and 6. The most common aberrations in a CK were translocations, numerical changes and dicentric chromosomes (with no effect on OS). Patients with aberrations of TP53 and ATM were shown to have adverse prognosis comparable to patients with a CK without these abnormalities. A stronger impact of a CK on OS of female and older CLL patients was observed. Conclusions: The determining of the presence of a CK is essential in modern clinical CLL practice. According to recent studies, the presence of a CK affects clinical and treatment decision-making.