Deletion 17p and/or TP53 mutations are important prognostic factors1-3

Del 17p occurs in about 10% of the CLL population at the time of diagnosis2,4

  • Del 17p is associated with inferior prognosis and resistance to standard chemotherapy regimens1
  • iwCLL and NCCN Guidelines recommend repeat testing del 17p and TP53 mutations prior to any subsequent treatment.1,8

The prognostic importance of del 17p and/or TP53 mutations1

  • Del 17p was identified as an independent factor in the CLL-IPI for overall survival by multivariate analysis5
  • CLL patients who have TP53 mutation may have a faster progression of disease, resistance to traditional therapy and a less favorable outcome.6

Changes in iwCLL Guidelines1,7

  Baseline testing for 17p deletion
  iwCLL 2018 iwCLL 2008
General practice ALWAYS Desirable
Clinical trial ALWAYS Always

 

  Baseline testing for TP53 mutation
  iwCLL 2018 iwCLL 2008
General practice ALWAYS Not included
Clinical trial ALWAYS Not included

Bolding indicates updates.

CLL=chronic lymphocytic leukemia, CLL-IPI=chronic lymphocytic leukemia-international prognostic index, del=deletion, iwCLL=International Workshop on Chronic Lymphocytic Leukemia.

Increased emphasis on del 11q

Guidelines now also underscore testing for 11q deletion—another important prognostic indicator.2

Learn more

References: 1.  Hallek M, Cheson BD, Catovsky D, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018;131(25):2745-2760. 2. Döhner H, Stilgenbauer S, Benner A, et al. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med. 2000;343(26):1910-1916. 3. Stilgenbauer S, Schnaiter A, Paschka P, et al. Gene mutations and treatment outcome in chronic lymphocytic leukemia: results from the CLL8 trial. Blood. 2014;123(21):3247-3254. 4. Grever MR, Lucas DM, Dewald GW, et al. Comprehensive assessment of genetic and molecular features predicting outcome in patients with chronic lymphocytic leukemia: results from the US Intergroup Phase III Trial E2997. J Clin Oncol. 2007;25(7):799-804. 5. The International CLL-IPI working group. An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol. 2016;17(6):779-790. 6.  Leukemia & Lymphoma Society. Chronic Lymphocytic Leukemia. https://www.lls.org/sites/default/files/file_assets/PS34_CLL_Booklet_2017_9_7FINAL.pdf. Revised 2017. Accessed March 7, 2019. 7. Hallek M, Cheson BD, Catovsky D, et al; International Workshop on Chronic Lymphocytic Leukemia. Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines. Blood. 2008;111(12):5446-5456. 8. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma V.4.2019. © National Comprehensive Cancer Network, Inc. 2019. All rights reserved. Accessed April 15, 2019. To view the most recent and complete version of the guideline, go online to NCCN.org.

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