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Clonal evolution in CLL patients as detected by FISH versus chromosome banding analysis, and its clinical significance
Author(s) -
Wawrzyniak Ewa,
Kotkowska Aleksandra,
Blonski Jerzy Z.,
SiemieniukRys Monika,
Ziolkowska Ewelina,
Giannopoulos Krzysztof,
Robak Tadeusz,
KoryckaWolowiec Anna
Publication year - 2014
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12215
Subject(s) - fluorescence in situ hybridization , karyotype , fish <actinopterygii> , biology , metaphase , chromosome , medicine , chromosome abnormality , cytogenetics , chronic lymphocytic leukemia , gastroenterology , genetics , leukemia , gene , fishery
The acquisition of new aberrations during the course of chronic lymphocytic leukemia ( CLL ) named clonal evolution ( CE ) is usually detected by one of the two methods: chromosome banding analysis ( CBA ) and interphase fluorescence in situ hybridization ( I ‐ FISH ). The purpose of this study was to compare the usefulness of FISH and CBA for detecting CE and to evaluate its influence on clinical outcome. FISH and CBA were performed at two time points: baseline and follow‐up. Thirty‐eight previously untreated patients with CLL were included in this study. CBA and I ‐ FISH revealed CE in 15 (39.5%) and 10 (26.3%) patients, respectively. High‐risk CE was detected in six cases by CBA and in five cases by I ‐ FISH . In four cases with CE‐dependent 17p abnormalities detected by CBA , metaphase FISH was needed for the confirmation of 17p13.1 deletion. Time from first‐line to second‐line treatment ( TTST ) and overall survival ( OS ) did not differ between patients with and without CE , irrespective of the CE ‐detecting method used. However, shorter OS ( P = 0.043) and TTST ( P = 0.006) were observed for the patients with potentially relevant CE (r CE ) detected by CBA , in which acquired aberrations were present in at least 20% of undivided cells and/or changed baseline karyotype to abnormal or complex and were not resulting from 13q deletion. Our results suggest that some, but not all, CE ‐dependent aberrations detected by CBA influence clinical outcome. Moreover, I ‐ FISH , which was aimed at detecting aberrations of prognostic significance, was found to be more precise than CBA in their detection, especially TP53 deletion.