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EHA 2025 | The optimal management of patients with CLL harbouring complex karyotype
Andrea Visentin, MD, PhD, University of Padua, Padua, Italy, discusses the optimal management of patients with chronic lymphocytic leukemia (CLL) harbouring complex karyotype. Dr Visentin hypothesizes that a fixed-duration treatment may be the best approach for these patients, as it decreases the risk of acquiring further mutations. This interview took place at the 30th Congress of the European Hematology Association (EHA) in Milan, Italy.
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Transcript
Complex karyotype is an emerging marker of adverse outcome in patients with chronic lymphocytic leukemia. We will hear much more in the next future how to optimize the treatment. Some of these patients also harbour TP53 aberration but some of them not, so we cannot know exactly which is the best treatment. We know that these patients with a complex karyotype, either with more than three, in particular those with more than five cytogenetic abnormalities, are characterized by genetic instability that favours the acquisition of additional genetic lesions and mutations...
Complex karyotype is an emerging marker of adverse outcome in patients with chronic lymphocytic leukemia. We will hear much more in the next future how to optimize the treatment. Some of these patients also harbour TP53 aberration but some of them not, so we cannot know exactly which is the best treatment. We know that these patients with a complex karyotype, either with more than three, in particular those with more than five cytogenetic abnormalities, are characterized by genetic instability that favours the acquisition of additional genetic lesions and mutations. So if we treat this kind of patient with a continuous treatment, we take the risk of developing a mutation associated with resistance to the treatment, which might impair further lines of therapy. So what we hypothesized in this review is that the best treatment for a patient with complex karyotype is to expose the patient to a fixed-duration treatment in order to mitigate, to decrease the risk of acquisition of further mutations that might impair the further response to the next line of therapies.
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