Prognostic Implication of Karyotypic Evaluation in Patients With Richter Transformation in the Modern Era

Le résumé fourni par la source

To the Editor, Evaluation of karyotype is a standard prognostic test for patients with chronic lymphocytic leukemia (CLL) and Richter transformation (RT), defined herein as diffuse large B-cell lymphoma in the setting of CLL, as karyotype abnormalities in malignant cells have been repeatedly shown to correlate with worse outcomes. During the time when chemoimmunotherapy (CIT) was the predominant treatment for CLL, complex karyotype (CK, defined as ≥ 3 chromosome abnormalities) was a strong adverse prognostic indicator for survival. Patient outcomes could be further stratified by applying a highly complex karyotype (high-CK) threshold of ≥ 5 chromosome abnormalities. With targeted agents, such as the BTK inhibitor ibrutinib and the BCL2 inhibitor venetoclax, CK has also been associated with inferior outcomes. Further, in patients with CLL treated with ibrutinib, karyotypic complexity was prognostic as a continuous variable, where each additional abnormality was associated with worse survival enumerating up to 20 abnormalities.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.