Retrospective multicentre study comparing survival outcomes in chronic lymphocytic leukaemia (CLL) with genetic risk stratification (2023)

Type of publication:Conference abstract

Author(s):Qureshi I.; Mandal A.; Foster N.; Rose S.; Sharma K.; McIlroy G.; *Cherian G.; *Lane S.; Wandroo F.; Talbot G.; Pemberton N.; Parry H.; Moss P.; Paneesha S.

Citation:British Journal of Haematology. Conference: 63rd Annual Scientific Meeting of the British Society for Haematology. Birmingham United Kingdom. 201(Supplement 1) (pp 67-68), 2023. Date of Publication: April 2023.

Abstract:Purpose: This retrospective West Midlands multicentre study of CLL patients was conducted to review results of genetic testing in CLL patients and impact on survival. Method(s): 349 patients across the West Midlands were included in this retrospective study collected between December 2018 and March 2022. Clinical centres were asked to obtain data relating to the type and number of lines of treatment, overall response and reported genetic abnormalities. Treatment and response were categorised as per international workshop on chronic lymphocytic leukaemia (iwCLL) criteria.1 Genetic testing comprised fluorescence in situ hybridisation (FISH) for copy number abnormalities of 17p &11q, IgHV mutation status and Oxford Gene Technology CLL Next-Generation Sequencing (NGS) Panel to detect sequence variants in key genes associated with CLL (including NOTCH1, SF3B1, BIRC3, ATM and TP53). Patients were risk stratified into good, poor or not poor risk categories as per Rodriguez-Vicente et al.2 Statistical Analysis and Results: For 349 patients analysed, 143 (41%) patients were under active surveillance, and 206 (59%) patients received 1st line treatment. Out of the 206 patients that received 1st line treatment, 92 (44%) patients proceeded to 2nd line treatment, 31 (15%) patients proceeded to 3rd line treatment and 21 (10%) of patients required treatment beyond 3rd line Within the poor risk category, 173 patients were identified with 38 had TP53 deletion or mutation and 135 patients had other poor risk mutations such as NOTCH1, SF3B1, ATM. Statistical analysis did not show a difference in survival either from the diagnosis or from the date of NGS sample in the two groups of high-risk patients. Conclusion(s): The data identifies a cohort of patients with poor outcome that are negative for TP53 mutation, highlighting the importance of NGS in CLL patients at the point of treatment.