Predicting Prognosis in Chronic Lymphocytic Leukemia in the Contemporary Era

摘要: Importance Next-generation sequencing has identified new genetic markers that have altered prognosis for patients with chronic lymphocytic leukemia (CLL) at diagnosis. Understanding the significance of these prognostic indicators and recognizing their potential impact on treatment selection patients' outcomes is critical clinicians investigators. Objective To review novel factors CLL diagnosis shown an this disease. Evidence Literature from January 2004 through December 2014 was searched in PubMed, Cochrane Central Register Controlled Trials, Scopus to identify English-language, peer-reviewed articles clinical (TP53, ATM, NOTCH1, SF3B1, BIRC3, MYD88). Reference lists were subsequently reviewed additional articles. A total 450 identified, 48 meeting inclusion criteria reviewed. Findings Among reviewed, chromosomal aberrations been validated are currently used clinically predict prognosis. Patients 17p13.1 deletion poor response chemoimmunotherapy treated differently, some undergoing allogeneic transplantation first remission. CD38 ZAP-70 status malignant cells unmutated immunoglobulin variable heavy chain gene similarly adverse prognosis, but implications not proven. The presence TP53 ATM mutations predicts worse which corroborated various studies. lower responses chemoimmunotherapy. Furthermore, inferior progression-free survival overall survival, independent other factors. carrying NOTCH1 SF3B1 prognosis; mutation rates standard BIRC3 requires further confirmation. Conclusions relevance heterogeneous course likely explained by underlying molecular Moving forward, analyzing recommended better prognostication.