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IGH translocations in chronic lymphocytic leukemia: Clinicopathologic features and clinical outcomes
Author(s) -
Fang Hong,
Reichard Kaaren K.,
Rabe Kari G.,
Hanson Curtis A.,
Call Timothy G.,
Ding Wei,
Kenderian Saad S.,
Muchtar Eli,
Schwager Susan M.,
Leis Jose F.,
ChananKhan Asher A.,
Slager Susan L.,
Braggio Esteban,
Smoley Stephanie A.,
Kay Neil E.,
Shanafelt Tait D.,
Van Dyke Daniel L.,
Parikh Sameer A.
Publication year - 2019
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.25385
Subject(s) - chromosomal translocation , chronic lymphocytic leukemia , medicine , gastroenterology , hazard ratio , leukemia , oncology , immunology , biology , confidence interval , genetics , gene
The prevalence, clinicopathologic correlates, and outcomes of previously untreated chronic lymphocytic leukemia (CLL) patients with IGH‐BCL2 and IGH‐BCL3 translocations are not well known. Using the Mayo Clinic CLL database, we identified patients seen between March 1, 2002 and September 30, 2016 who had FISH testing performed within 3 years of CLL diagnosis. The prognostic profile, time to first therapy (TTT), and overall survival (OS) of patients with IGH‐BCL2 and IGH‐BCL3 translocation were compared to patients without these abnormalities (non‐ IGH group). Of 1684 patients who met the inclusion criteria, 38 (2.2%) had IGH‐BCL2 , and 16 (0.9%) had IGH‐BCL3 translocation at diagnosis. Patients with IGH‐BCL3 translocation were more likely to have high and very‐high CLL‐International Prognostic Index, compared to patients with IGH‐BCL2 translocation and the non‐ IGH group. The 5‐year probability of requiring therapy was significantly higher for IGH‐BCL3 compared to IGH‐BCL2 and non‐ IGH groups (84% vs 33% vs 29%, respectively, P < 0.0001). The 5‐year OS was significantly shorter for IGH‐BCL3 compared to IGH‐BCL2 and non‐ IGH groups (45% vs 89% vs 86%, respectively, P < 0.0001). On multivariable analyses, IGH‐BCL3 translocation was associated with a shorter TTT (hazard ratio [HR] = 2.7; P = 0.005) and shorter OS (HR = 5.5; P < 0.0001); IGH‐BCL2 translocation did not impact TTT and OS. In conclusion, approximately 3% of all newly diagnosed CLL patients have either an IGH‐BCL2 or IGH‐BCL3 translocation. Patients with IGH‐BCL3 translocations have a distinct prognostic profile and outcome. These results support the inclusion of an IGH probe during the routine evaluation of FISH abnormalities in newly diagnosed CLL.