Prognostic factors in chronic lymphocytic leukemia

Author: Vibor Milunović, Dora Dragčević, Tihana Duić, Dora Bežovan, Ana Bojanić, Karla Mišura Jakobac, Marin Kursar, Marko Martinović, Delfa Radić- Krišto, Slobodanka Ostojić Kolonić, Slavko Gašparov, Inga Mandac Smoljanović

Abstract: The treatment of chronic lymphocytic with the introduction of targeted drugs and abandonment of chemoimmunotherapy is one of the mayor advances in malignant hematology. Yet, the main question is if we have truly overcome adverse prognostic factors. Despite the advancement, the deletion of the short arm of the chromosome 17 and the mutation of the tumor suppressor p53 remain adverse prognostic factors. Furthermore, other genomic alterations are becoming important and by the introduction of novel techniques due to greater availability. On the other hand, certain subpopulation of patients can achieve functional cure. Minimal residual disease is important in concerning the outcomes and future treatments in this population. In conclusion, in the modern era we can stratify the risk of individual patient and, therefore, personalize the treatment.

Key words:
chronic lymphocytic leukemia; genomics; minimal residual disease; IGHV; prognostic factors; tumor suppressor 53