ASH 2024 | Complex karyotype, but not isolated TP53 mutation, predicts OS in CLL in the era of targeted therapy

This year we looked into our database of patients who were diagnosed with CLL over the last 10 years to evaluate what types of risk factors are important for overall survival in the setting of targeted therapy, now being the primary treatment for our patients. We evaluated the CLL-IPI factors, all of which were still significant in our population, but we also looked at complex karyotype and found that that was quite significant as a predictor, defined as either three aberrations or five or more aberrations. 

So we then did a multivariable analysis, including that, into the IPI factors and found that actually age, beta-2 microglobulin, and complex karyotype were the three strongest predictors now in the era of targeted therapy for overall survival. And this is very interesting because we know that, for example, unmutated IGHV patients do so much better with targeted therapy than they did before, and that factor didn’t seem to be as significant. 

And then the other interesting thing is that isolated TP53 mutation was not significant in the cohort. And even 17p deletion, which was significant together with TP53 aberration in the univariable analysis, fell out when we looked at the multivariable analysis of complex karyotype. And I think perhaps this suggests that the significant overlap between 17p deletion and complex karyotype is a marker for who the really highest-risk patients are in that subgroup. And that subgroup did have worse overall survival compared to our overall cohort. And so we still do need to improve our targeted therapy for them.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.