2017 April 10

Members of the Chronic Lymphocytic Leukemia (CLL) working group of campus IJC-Badalona have just published a work in the prestigious “American Journal of Hematology”.

This work was led by Dr. Maria Joao Baptista, Dr. Isabel Granada and Dr. Francesc Solé.

Members of the Chronic Lymphocytic Leukemia (CLL) working group of campus IJC-Badalona have just published a work in the prestigious “American Journal of Hematology”. This work is the result of the collaboration of the CLL working group of IJC-ICO-HGTIP with the Spanish Group of Cytogenetics (GCECGH; “Grupo Cooperativo Español de Citogenética Hematológica”) and the Spanish Group of CLL (GELLC; “Grupo Español de Leucemia Linfática Crónica”). It is also co-author of this work, Dr. Carol Moreno from the CLL group of the campus Sant Pau.

This is the first study analyzing the impact of monosomal karyotype on outcomes of patients with CLL. The term “monosomal karyotype” (MK) is used to describe karyotypes with two monosomies or with one monosomy and a structural abnormality, and it was used for the first time by Breems et al in 2008, who first reported the prognostic value of MK in Acute Myeloid Leukemia.

The IJC researchers found out that in CLL, the presence of MK was associated with poor prognostic factors such as del(17p), unmutated IGHV genes or karyotypic complexity. Patients with MK had shorter overall survival and time to first treatment than patients without MK or than patients with other abnormal karyotypes. Moreover, In the subgroup of patients with del (17p), 35% had a MK and the shortest outcomes. MK helps identifying patients with poor prognosis particularly in the subgroup of patients with del (17p). These observations and the newer kayotyping techniques, argue in favor of reassessing conventional karyotype analysis on CLL. Due to the very poor prognosis of the subset of patients with del (17p) and MK, they should be closely followed up and maybe these patients could benefit from an early treatment onset. This issue should be study in the context of clinical trials, particularly in those trials employing the new inhibitors, to ascertain not only the advantage of the new molecules and combinations but also the benefit of treatment initiation before being fulfilled the criteria for treatment onset established in the current guide lines.

In summary, this type of work can only be done when a very high number of patients is studied and is a good example of the IJC policies and efforts. Although only a small percentage of patients present MK at diagnosis, and a even lesser the combined MK and del (17p), the identification of this cohort will allow the design of new strategies to overcome its dismal prognosis.

Dr Maria Joao Baptista Biography
Dr Francesc Solé Biography 

Link to publicatio: here