EHA 2025 | Disease prognostication in CLL: advancements and challenges

We know that prognostication is one of the most essential things for the patients. And if the patient comes and asks us, what does my disease mean, how long will I live, it’s always nice to have tools to tell them you’re more of a high-risk patient and you should be aware of this and that, or you have a very low risk of progression. So in the CLL12 we also sorted the patients by their risk group, so the intermediate to very high-risk patients received placebo or ibrutinib. And I mean historically we basically used clinical staging systems, clinical prognostication systems which also are still extremely important in my opinion. But what we can do now is use genetic markers, use different laboratory values that sort of lead us to have a fuller picture to see which patients actually benefit from different therapies or which patients can wait, like we saw in the CLL12 trial. So I think overall the combining of the genetic markers and the clinical tools is very, very important. I think it’s absolutely going to move in this direction to combine even further and to combine even more factors. I think at the moment one of the problems we have is that it’s not accessible, the sort of diagnostics we do. I mean in Germany we’re lucky we have a very good lab at our university hospital, but this is not the case for every country and it’s not as easily accessible as feasible and also it’s expensive to do these things. So I think it’s very important to make these methods, these diagnostics even more accessible also to like other countries that don’t have the health system or the money that other highly developed countries have.

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