Prognostic impact of genetic abnormalities in 536 first-line chronic lymphocytic leukaemia patients without 17p deletion treated with chemoimmunotherapy in two prospective trials: Focus on IGHV-mutated subgroups (a FILO study).

Nguyen-Khac, Florence;Baron, Marine;Guièze, Romain;Feugier, Pierre;on behalf the FILO (French Innovative Leukaemia Organization) Group;et.al.
(2024) British Journal of Haematology — Vol. 205, n° 2, p. 495-502 (2024)

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Authors
  • Nguyen-Khac, Florence
    Author
  • Baron, Marineorcid-logo
    Author
  • Guièze, Romain
    Author
  • Feugier, Pierre
    Author
  • Van Den Neste, Ericorcid-logoUCLouvain
    Author
  • on behalf the FILO (French Innovative Leukaemia Organization) Group
    Collaborator
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Abstract
The potential prognostic influence of genetic aberrations on chronic lymphocytic leukaemia (CLL) can vary based on various factors, such as the immunoglobulin heavy variable (IGHV) status. We conducted an integrative analysis on genetic abnormalities identified through cytogenetics and targeted next-generation sequencing in 536 CLL patients receiving first-line chemo(immuno)therapies (CIT) as part of two prospective trials. We evaluated the prognostic implications of the main abnormalities, with specific attention to their relative impact according to IGHV status. In the entire cohort, unmutated (UM)-IGHV, complex karyotype, del(11q) and ATM mutations correlated significantly with shorter progression-free survival (PFS). Focusing on the subset of mutated IGHV (M-IGHV) patients, univariate analysis showed that complex karyotype, del(11q), SF3B1 and SAMHD1 mutations were associated with significant lower PFS. The prognostic influence varied based on the patient's IGHV status, as these abnormalities did not affect outcomes in the UM-IGHV subgroup. TP53 mutations had no significant impact on outcomes in the M-IGHV subgroup. Our findings highlight the diverse prognostic influence of genetic aberrations depending on the IGHV status in symptomatic CLL patients receiving first-line CIT. The prognosis of gene mutations and cytogenetic abnormalities needs to be investigated with a compartmentalized methodology, taking into account the IGVH status of patients receiving first-line BTK and/or BCL2 inhibitors.
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Nguyen-Khac, F., Baron, M., Guièze, R., Feugier, P., Fayault, A., Raynaud, S., Troussard, X., Droin, N., Damm, F., Smagghe, L., Susin, S., Leblond, V., Dartigeas, C., Van Den Neste, E., Leprêtre, S., Bernard, O. A., & Roos-Weil, D. (2024). Prognostic impact of genetic abnormalities in 536 first-line chronic lymphocytic leukaemia patients without 17p deletion treated with chemoimmunotherapy in two prospective trials: Focus on IGHV-mutated subgroups (a FILO study). British Journal of Haematology, 205(2), 495-502. https://doi.org/10.1111/bjh.19459 (Original work published 2024)