Kategorie: Maligní lymfomy a leukémie
Číslo abstraktu: E1051
Autoři: Mgr. Jana Kotašková; RNDr. Jitka Malčíková, Ph.D.; Mgr. Eva Divíšková; Mgr. Šárka Pavlová, PhD; MUDr. Ester Mejstříková, Ph.D.; RNDr. Vladimíra Vallová (Vránová), Ph.D.; Mgr. Karla Plevová (roz. Malinová), Ph.D.; Mgr. Hana Plesingerová; prof. MUDr. Michael Doubek, Ph.D.; prof. MUDr. Jiří Mayer, CSc.; prof. RNDr. Šárka Pospíšilová, Ph.D.
In Chronic lymphocytic leukemia (CLL) four recurrent cytogenetic aberrations with different prognostic impact are routinely tested: deletions 11q, 13q, 17p and trisomy 12. Their prognostic impact is generally described using Dohner’s hierarchy: del17p > del 11q > tris 12 > normal > del 13q. The aberrations are usually tested once at the diagnosis but their spectra can change during disease evolution.
Repeated analysis of the four recurrent CLL cytogenetic aberrations was aimed to monitor the changes in aberration distribution in the different disease stages.
Four common cytogenetic aberrations (deletions 11q, 13q, 17p, and trisomy 12) were detected using interphase FISH analysis.
Based on the disease course and
therapy administration, CLL patients were stratified into two
groups: (A) patients with indolent disease – 16 % (52/335), no
treatment required, median follow-up 75 months; (B) patients with
progressive disease requiring therapy intervention either after an
inactive phase (56 %; 186/335; median time to first treatment 35
months; median follow-up 74 months), or soon after diagnosis (28 %;
97/335; median time to first treatment 14 months, median follow-up
In total, newly acquired cytogenetic aberration was detected in 33 % (109) from 335 repeatedly tested patients. In the indolent group A, 23 % (12/52) of patients gained a new aberration during follow-up. In almost all cases (92 %; 11/12) the newly acquired aberration was deletion 13q. In the progressive group B, patients were tested repeatedly before the first therapy and during relapse where possible. 11 % (30/283) of patients gained a new aberration already before therapy - 20 % (6/30) at inactive phase and 80 % (24/30) at active phase of CLL. Del 13q comprised 83% (5/6) of aberrations gained at inactive phase. The distribution of aberrations gained at active phase of CLL was following: del 13q in 63 % (15/24), del 17p in 17 % (4/24), del 11q in 13 % (3/24), and tris 12 in 7 % (2/24) of cases. 71 % (200/283) of CLL patients were tested again in progression after therapy. New chromosomal aberration was detected in 34 % (67/200) of cases: del 13q in 61 % (41/67), del 17p in 28 % (19/67), del 11q in 16 % (11/67), and tris 12 in 1 % (1/67).
In our study we showed that 33 % of
repeatedly tested patients acquired additional cytogenetic
aberrations during the CLL course. The most frequently acquired
aberration was 13q deletion (66 %). Regarding the disease activity,
deletion 13q comprised 92 % newly acquired aberrations among
patients with indolent CLL without clinical manifestation of the
disease progression. Surprisingly, 13q deletion comprised 60 % of
all aberrations acquired before therapy and 61 % of all aberrations
acquired after therapy also in the group with progressive disease.
Our data suggests that the proportion of the deletion 13q among
newly acquired aberrations appears independent on the disease
activity and therapy intervention. In contrary, 17p deletion
acquisition increases with disease activity and foregoing therapy,
13 % before vs. 28 % cases after treatment in progressive
Supported by: IGA MZCR NT13519, IGA MZCR NT13493, CZ.1.05/1.1.00/02.0068, CZ.1.07/2.3.00/30.0009, NGS-PTL/2012-2015/no.306242, MSMT-CR (2013-2015, no.7E13008)
Keyword(s): B cell chronic lymphocytic leukemia, Cytogenetic abnormalities, FISH
Datum přednesení příspěvku: 12. 6. 2015