These conclusions are corroborated by the current International Workshop on CLL (iwCLL) guidelines for the diagnosis, indications for treatment, response assessment, and supportive management of CLL. Moreover, both presenters concluded that although the prognostic vs predictive value of IGHV and TP53mutational status remains uncertain, all patients with CLL in clinical practice or enrolled on clinical trials should undergo fluorescence in situ hybridization (FISH) testing, TP53 mutational analysis, and IGHV mutational analysis.
Therefore, some debate exists regarding the current utility of these markers in patients receiving continuous therapy with BTK inhibitors or time-limited therapy with venetoclax (Venclexta).ĭuring the debate, Inhye Ahn, MD, of Dana-Farber Cancer Institute, spoke in favor of using old prognostic markers in CLL, whereas Steven Coutre, MD, a professor of medicine at Stanford University, argued against using old prognostic markers.įollowing both presentations, 89% of audience members voted in favor of using old prognostic markers in CLL management, according to a virtual poll. 1,2Īlthough several markers of CLL activity and growth, notably IGHV and TP53 mutational status, are predictive of outcomes with fludarabine, cyclophosphamide, and rituximab (Rituxan FCR), the advent of targeted therapy has largely replaced chemoimmunotherapy as a treatment option for patients with CLL. IGHV and TP53 remain clinical prognostic importance in patients with chronic lymphocytic leukemia (CLL), despite many prognostic markers for chemoimmunotherapy losing their clinically relevance in the context of targeted therapies for patients, according to a debate that took place during the 2021 SOHO Annual Meeting.
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