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ESH CLL 2026 | Key risk markers guiding treatment decisions in CLL
Ferran Nadeu, PhD, University of Barcelona, Barcelona, Spain, discusses the most important biomarkers guiding risk stratification and treatment decisions in chronic lymphocytic leukemia (CLL), including TP53 alterations, IGHV mutation status, and complex karyotype. He explains how these markers continue to inform therapeutic strategies in the era of targeted therapies. This interview took place at the ESH CLL 2026 congress in Stockholm, Sweden.
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Transcript
We know from all the recent guidelines, from the international guidelines and also different national guidelines, that TP53 alterations still recognize the high-risk patients, which may benefit from continuous BTK inhibition or novel targets, although it’s true also that there are some studies suggesting that they could also have good responses in time-limited therapies. But I would say that TP53 still remains as the key marker for high-risk CLL patients...
We know from all the recent guidelines, from the international guidelines and also different national guidelines, that TP53 alterations still recognize the high-risk patients, which may benefit from continuous BTK inhibition or novel targets, although it’s true also that there are some studies suggesting that they could also have good responses in time-limited therapies. But I would say that TP53 still remains as the key marker for high-risk CLL patients. We could add here potentially the complex karyotype, which is also associated with poor responses in different studies, although this has not been introduced in most clinical guidelines yet. And then we have IGHV mutational status, which also identifies these two subtypes of CLL which might have different responses to different therapies or can help us to understand how the response will be if shorter or longer to different therapies.
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