Patients with chronic lymphocytic leukemia and complex karyotype show an adverse outcome even in absence of TP53/ATM FISH deletions
Por:
Puiggros, A, Collado, R, Calasanz, MJ, Ortega, M, Ruiz-Xiville, N, Rivas-Delgado, A, Luno, E, Gonzalez, T, Navarro, B, Garcia-Malo, M, Valiente, A, Hernandez, JA, Ardanaz, MT, Pinan, MA, Blanco, ML, Hernandez-Sanchez, M, Batlle-Lopez, A, Salgado, R, Salido, M, Ferrer, A, Abrisqueta, P, Gimeno, E, Abella, E, Ferra, C, Terol, MJ, Ortuno, F, Costa, D, Moreno, C, Carbonell, F, Bosch, F, Delgado, J, Espinet, B
Publicada:
1 ago 2017
Resumen:
Genomic complexity identified by chromosome banding analysis (CBA) predicts a worse clinical outcome in CLL patients treated either with standard or new treatments. Herein, we analyzed the clinical impact of complex karyotypes (CK) with or without high-risk FISH deletions (ATM and/or TP53, HR-FISH) in a cohort of 1045 untreated MBL/CLL patients. In all, 99/1045 (9.5%) patients displayed a CK. Despite ATM and TP53 deletions were more common in CK (25% vs 7%; P < 0.001; 40% vs 5%; P < 0.001, respectively), only 44% (40/90) patients with TP53 deletions showed a CK. CK group showed a significant higher two-year cumulative incidence of treatment (48% vs 20%; P < 0.001), as well as a shorter overall survival (OS) (79 mo vs not reached; P < 0.001). When patients were categorized regarding CK and HR-FISH, those with both characteristics showed the worst median OS (52 mo) being clearly distinct from those non-CK and non-HR-FISH (median not reached), but no significant differences were detected between cases with only CK or HR-FISH. Both CK and TP53 deletion remained statistically significant in the multivariate analysis for OS. In conclusion, CK group is globally associated with advanced disease and poor prognostic markers. Further investigation in larger cohorts with CK lacking HR-FISH is needed to elucidate which mechanisms underlie the poor outcome of this subgroup.
Filiaciones:
Puiggros, A:
Hosp del Mar, Serv Patol, Lab Citol Hematol, Lab Citogenet Mol, Barcelona, Spain
Hosp del Mar, Serv Hematol, Barcelona, Spain
Inst Hosp del Mar Invest Med IMIM, Programa Recerca Canc, Grp Recerca Translac Neoplasies Hematol, Barcelona, Spain
Collado, R:
Consorcio Hosp Gen Univ, Serv Hematol, Valencia, Spain
Calasanz, MJ:
Univ Navarra, Dept Genet, Serv Citogenet, Pamplona, Spain
Ortega, M:
Hosp Valle De Hebron, Lab Citogenet, Barcelona, Spain
Hosp Valle De Hebron, Serv Hematol, Barcelona, Spain
Ruiz-Xiville, N:
Univ Autonoma Barcelona, ICO Hosp Germans Trias & Pujol, Serv Lab Hematol, Inst Recerca Leucemia Josep Carreras IJC, Badalona, Spain
Rivas-Delgado, A:
Univ Barcelona, IDIBAPS, Hosp Clin, Secc Hematopatol, Barcelona, Spain
Luno, E:
Hosp Univ Cent Asturias, Serv Hematol, Oviedo, Spain
Gonzalez, T:
Fdn Publ Galega Med Xen, Santiago De Compostela, Spain
Navarro, B:
Hosp Clin Univ Valencia, Serv Hematol & Oncol Med, Valencia, Spain
Garcia-Malo, M:
Hosp Univ Morales Meseguer, Ctr Reg Hemodonac, IMIB Arrixaca, Serv Hematol & Oncol Med, Murcia, Spain
Valiente, A:
Complejo Hosp Navarra, Serv Genet, Pamplona, Spain
Complejo Hosp Navarra, Serv Hematol, Pamplona, Spain
Hernandez, JA:
Hosp Univ Infanta Leonor, Serv Hematol, Madrid, Spain
Ardanaz, MT:
Hosp Txagorritxu, Serv Hematol, Vitoria, Spain
Pinan, MA:
Hosp Cruces, Serv Hematol, Bilbao, Spain
Blanco, ML:
Hosp Univ Santa Creu & St Pau, Serv Hematol, Barcelona, Spain
Hernandez-Sanchez, M:
Univ Salamanca, CSIC, Ctr Invest Canc, Serv Hematol,Hosp Univ Salamanca,IBSAL,IBMCC, Salamanca, Spain
Batlle-Lopez, A:
Hosp Univ Marques de Valdecilla, Serv Hematol, Santander, Spain
Salgado, R:
Fdn Jimenez Diaz, Lab Citogenet, Serv Hematol, Madrid, Spain
Salido, M:
Hosp del Mar, Serv Patol, Lab Citol Hematol, Lab Citogenet Mol, Barcelona, Spain
Hosp del Mar, Serv Hematol, Barcelona, Spain
Inst Hosp del Mar Invest Med IMIM, Programa Recerca Canc, Grp Recerca Translac Neoplasies Hematol, Barcelona, Spain
Ferrer, A:
Hosp del Mar, Serv Patol, Lab Citol Hematol, Lab Citogenet Mol, Barcelona, Spain
Hosp del Mar, Serv Hematol, Barcelona, Spain
Inst Hosp del Mar Invest Med IMIM, Programa Recerca Canc, Grp Recerca Translac Neoplasies Hematol, Barcelona, Spain
Abrisqueta, P:
Hosp Valle De Hebron, Lab Citogenet, Barcelona, Spain
Hosp Valle De Hebron, Serv Hematol, Barcelona, Spain
Gimeno, E:
Hosp del Mar, Serv Patol, Lab Citol Hematol, Lab Citogenet Mol, Barcelona, Spain
Hosp del Mar, Serv Hematol, Barcelona, Spain
Abella, E:
Hosp del Mar, Serv Patol, Lab Citol Hematol, Lab Citogenet Mol, Barcelona, Spain
Hosp del Mar, Serv Hematol, Barcelona, Spain
Ferra, C:
Univ Autonoma Barcelona, ICO Hosp Germans Trias & Pujol, Serv Lab Hematol, Inst Recerca Leucemia Josep Carreras IJC, Badalona, Spain
Terol, MJ:
Hosp Clin Univ Valencia, Serv Hematol & Oncol Med, Valencia, Spain
Ortuno, F:
Hosp Univ Morales Meseguer, Ctr Reg Hemodonac, IMIB Arrixaca, Serv Hematol & Oncol Med, Murcia, Spain
Costa, D:
Univ Barcelona, IDIBAPS, Hosp Clin, Secc Hematopatol, Barcelona, Spain
Moreno, C:
Hosp Univ Santa Creu & St Pau, Serv Hematol, Barcelona, Spain
Carbonell, F:
Consorcio Hosp Gen Univ, Serv Hematol, Valencia, Spain
Bosch, F:
Hosp Valle De Hebron, Lab Citogenet, Barcelona, Spain
Hosp Valle De Hebron, Serv Hematol, Barcelona, Spain
Delgado, J:
Univ Barcelona, IDIBAPS, Hosp Clin, Secc Hematopatol, Barcelona, Spain
Espinet, B:
Hosp del Mar, Serv Patol, Lab Citol Hematol, Lab Citogenet Mol, Barcelona, Spain
Hosp del Mar, Serv Hematol, Barcelona, Spain
Inst Hosp del Mar Invest Med IMIM, Programa Recerca Canc, Grp Recerca Translac Neoplasies Hematol, Barcelona, Spain
Green Published, Hybrid Gold
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