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Do complex cytogenetics have any therapeutic or prognostic relevance in CLL?
Patient in their 60s with TP53 mutation by NGS, treated 12 years ago with FCR, then at first relapse 2 years ago started ibrutinib. Bone marrow biopsy performed upon progression while still on ibrutinib demonstrated > 9 chromosomal abnormalities on karyotype, but no dysplatic morphology to suggest MDS.
Answer from: Medical Oncologist at Academic Institution
In this patient, the finding of a TP53 mutation trumps all, including complex karyotype. In the absence of TP53 mutation or deletion of 17p13.1 (the TP53 locus) on FISH, complex karyotype of 5 or greater abnormalities is generally associated with shorter time to treatment and PFS on both chemoimmuno...
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