Research Article
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Year 2025, Volume: 15 Issue: 2, 135 - 144, 29.08.2025
https://doi.org/10.26650/experimed.1659966

Abstract

References

  • 1. Hallek M. Chronic lymphocytic leukemia: 2025 update on the epidemiology, pathogenesis, diagnosis, and therapy. Am J Hematol 2025; 100(3): 450-80. google scholar
  • 2. Shadman M. Diagnosis and treatment of chronic lymphocytic leukemia: a review. JAMA 2023;329(11): 918-32. google scholar
  • 3. Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS. Clinical staging of chronic lymphocytic leukemia Blood 1975; 46(2): 219-34. google scholar
  • 4. Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer 1981; 48(1): 198-206. google scholar
  • 5. Tadmor T, Levy I. Richter transformation in chronic lymphocytic leukemia: update in the era of novel agents. Cancers (Basel) 2021; 13(20): 5141. google scholar
  • 6. Döhner H, Stilgenbauer S, Benner A, Leupolt E, Kröber A, Bullinger L, et al. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med 2000; 343(26): 1910-6. google scholar
  • 7. Rosenquist R, Cortese D, Bhoi S, Mansouri L, Gunnarsson R. Prognostic markers and their clinical applicability in chronic lymphocytic leukemia: where do we stand? Leuk Lymphoma 2013; 54(11): 2351-64. google scholar
  • 8. Innocenti I, Benintende G, Tomasso A, Fresa A, Autore F, Larocca LM, et al. Richter transformation in Chronic Lymphocytic Leukemia. Hematol Oncol 2023; 41(3): 293-300. google scholar
  • 9. Van Dyke DL, Werner L, Rassenti LZ, Neuberg D, Ghia E, Heerema NA, et al. The Dohner fluorescence in situ hybridization prognostic classification of chronic lymphocytic leukaemia (CLL): the CLL Research Consortium experience. Br J Haematol 2016; 173(1): 105-13. google scholar
  • 10. Roos-Weil D, Nguyen-Khac F, Chevret S, Touzeau C, Roux C, Lejeune J, et al. FILO working group. Mutational and cytogenetic analyses of 188 CLL patients with trisomy 12: A retrospective study from the French Innovative Leukemia Organization (FILO) working group. Genes Chromosomes Cancer 2018; 57(11): 533-40. google scholar
  • 11. Puiggros A, Blanco G, Espinet B. Genetic abnormalities in chronic lymphocytic leukemia: where we are and where we go. Biomed Res Int 2014; 2014: 435983. google scholar
  • 12. Strati P, Abruzzo LV, Wierda WG, O'Brien S, Ferrajoli A, Keating MJ. Second cancers and Richter transformation are the leading causes of death in patients with trisomy 12 chronic lymphocytic leukemia. Clin Lymphoma Myeloma Leuk 2015; 15(7): 420-27. google scholar
  • 13. Del Giudice I, Rossi D, Chiaretti S, Marinelli M, Tavolaro S, Gabrielli S, et al. NOTCH1 mutations in +12 chronic lymphocytic leukemia (CLL) confer an unfavorable prognosis, induce a distinctive transcriptional profiling and refine the intermediate prognosis of +12 CLL. Haematologica 2012; 97(3): 437-41. google scholar
  • 14. Van Dyke DL, Shanafelt TD, Call TG, Zent CS, Smoley SA, Rabe KG, et al. A comprehensive evaluation of the prognostic significance of 13q deletions in patients with B-chronic lymphocytic leukaemia. Br J Haematol 2010; 148(4): 544-50. google scholar
  • 15. Stankovic T, Skowronska A. The role of ATM mutations and 11q deletions in disease progression in chronic lymphocytic leukemia. Leuk Lymphoma 2014; 55(6): 1227-39. google scholar
  • 16. De Viron E, Michaux L, Put N, Bontemps F, Van Den Neste E. Present status and perspectives in functional analysis of p53 in chronic lymphocytic leukemia. Leuk Lymphoma 2012; 53(8): 1445-51. google scholar
  • 17. Te Raa GD, Kater AP. TP53 dysfunction in CLL: Implications for prognosis and treatment. Best Pract Res Clin Haematol 2016; 29(1): 90-9. google scholar
  • 18. Kwok M, Agathanggelou A, Davies N, Stankovic T. Targeting the p53 pathway in CLL: state of the art and future perspectives. Cancers (Basel) 2021; 13(18): 4681. google scholar
  • 19. Malcikova J, Smardova J, Rocnova L, Tichy B, Kuglik P, Vranova V, et al. Monoallelic and biallelic inactivation of TP53 gene in chronic lymphocytic leukemia: selection, impact on survival, and response to DNA damage. Blood 2009; 114(26): 5307-14. google scholar
  • 20. Catherwood MA, Gonzalez D, Donaldson D, Clifford R, Mills K, Thornton P. Relevance of TP53 for CLL diagnostics. J Clin Pathol 2019; 72(5): 343-46. google scholar
  • 21. Cuneo A, Rigolin GM, Bigoni R, De Angeli C, Veronese A, Cavazzini F, et al. Chronic lymphocytic leukemia with 6q- shows distinct hematological features and intermediate prognosis. Leukemia 2004; 18(3): 476-83. google scholar
  • 22. Audil HY, Hampel PJ, Van Dyke DL, Achenbach SJ, Rabe KG, Smoley SA, et al. The prognostic significance of del6q23 in chronic lymphocytic leukemia. Am J Hematol 2021; 96(6): E203-E206. google scholar
  • 23. Jarosova M, Hruba M, Oltova A, Plevova K, Kruzova L, Kriegova E, et al. Chromosome 6q deletion correlates with poor prognosis and low relative expression of FOXO3 in chronic lymphocytic leukemia patients. Am J Hematol 2017; 92(10): E604-E607. google scholar
  • 24. Qiu HX, Xu W, Cao XS, Zhou M, Shen YF, Xu YL, et al. Cytogenetic characterisation in Chinese patients with chronic lymphocytic leukemia: a prospective, multicenter study on 143 cases analysed with interphase fluorescence in situ hybridisation. Leuk Lymphoma 2008; 49(10): 1887-92. google scholar
  • 25. Wang DM, Miao KR, Fan L, Qiu HR, Fang C, Zhu DX, et al. Intermediate prognosis of 6q deletion in chronic lymphocytic leukemia. Leuk Lymphoma 2011; 52(2): 230-37. google scholar
  • 26. Cavazzini F, Ciccone M, Negrini M, Rigolin GM, Cuneo A. Clinicobiologic importance of cytogenetic lesions in chronic lymphocytic leukemia. Expert Rev Hematol 2009; 2(3): 305-14. google scholar
  • 27. Davids MS, Vartanov A, Werner L, Neuberg D, Dal Cin P, Brown JR. Controversial fluorescence in situ hybridization cytogenetic abnormalities in chronic lymphocytic leukaemia: new insights from a large cohort. Br J Haematol 2015; 170(5): 694-703. google scholar
  • 28. Montserrat E, Bauman T, Delgado J. Present and future of personalized medicine in CLL. Best Pract Res Clin Haematol 2016; 29(1): 100-10. google scholar
  • 29. Wan Mohamad Zamri WN, Mohd Yunus N, Abdul Aziz AA, Zulkipli NN, Sulong S. Perspectives on the application of cytogenomic approaches in chronic lymphocytic leukaemia. diagnostics (Basel) 2023; 13(5): 964. google scholar
  • 30. Strati P, Parikh SA, Chaffee KG, Kay NE, Call TG, Achenbach SJ, et al. Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study. Br J Haematol 2017; 178(3): 394-402. google scholar

Clinical Significance of Cytogenetic Abnormalities Detected by FISH in CLL: Insights from a Real-World Single-Centre Cohort

Year 2025, Volume: 15 Issue: 2, 135 - 144, 29.08.2025
https://doi.org/10.26650/experimed.1659966

Abstract

Objective: Chronic lymphocytic leukemia (CLL) is a hematologic malignancy that predominantly affects the elderly. This study aimed to investigate cytogenetic alterations that could be used for risk assessment and treatment decisions in patients with CLL in relation to clinical parameters and outcomes.

Materials and Methods: Peripheral blood samples from 101 CLL patients either newly diagnosed or previously diagnosed but untreated were analyzed using interphase fluorescence in situ hybridization (I-FISH) method with a CLL panel probe set. The associations among cytogenetic abnormalities, clinical features, treatment indications, and outcomes were statistically evaluated.

Results: FISH analysis revealed statistically significant associations between specific cytogenetic abnor malities and clinical features. del(13q) and ATM deletion were significantly associated with large/sympto matic/progressive lymphadenopathy (LAP); ATM deletion was also linked to progressive splenomegaly. Regarding the causes of death, P53 deletion was significantly associated with secondary solid neoplasms and acute decompensated heart failure; trisomy 12 with disease progression and secondary solid neoplasms; and immunoglobulin heavy chain gene (IGH) rearrangement with tumor lysis syndrome. No significant difference in the overall survival was observed between the treated and untreated CLL patients.

Conclusion: If validated in larger, multicenter cohorts, the novel associations identified between cytogenetic abnormalities and both treatment indications and causes of death could help guide the management of CLL.

Ethical Statement

This study was obtained from the Istanbul Medical Faculty Clinical Research Ethics Committee (Decision date/number: November 17, 2023/23).

Thanks

The authors would like to thank Dr. Ali Uçur, who passed away during the pandemic, for his great support in molecular cytogenetic analysis.

References

  • 1. Hallek M. Chronic lymphocytic leukemia: 2025 update on the epidemiology, pathogenesis, diagnosis, and therapy. Am J Hematol 2025; 100(3): 450-80. google scholar
  • 2. Shadman M. Diagnosis and treatment of chronic lymphocytic leukemia: a review. JAMA 2023;329(11): 918-32. google scholar
  • 3. Rai KR, Sawitsky A, Cronkite EP, Chanana AD, Levy RN, Pasternack BS. Clinical staging of chronic lymphocytic leukemia Blood 1975; 46(2): 219-34. google scholar
  • 4. Binet JL, Auquier A, Dighiero G, Chastang C, Piguet H, Goasguen J, et al. A new prognostic classification of chronic lymphocytic leukemia derived from a multivariate survival analysis. Cancer 1981; 48(1): 198-206. google scholar
  • 5. Tadmor T, Levy I. Richter transformation in chronic lymphocytic leukemia: update in the era of novel agents. Cancers (Basel) 2021; 13(20): 5141. google scholar
  • 6. Döhner H, Stilgenbauer S, Benner A, Leupolt E, Kröber A, Bullinger L, et al. Genomic aberrations and survival in chronic lymphocytic leukemia. N Engl J Med 2000; 343(26): 1910-6. google scholar
  • 7. Rosenquist R, Cortese D, Bhoi S, Mansouri L, Gunnarsson R. Prognostic markers and their clinical applicability in chronic lymphocytic leukemia: where do we stand? Leuk Lymphoma 2013; 54(11): 2351-64. google scholar
  • 8. Innocenti I, Benintende G, Tomasso A, Fresa A, Autore F, Larocca LM, et al. Richter transformation in Chronic Lymphocytic Leukemia. Hematol Oncol 2023; 41(3): 293-300. google scholar
  • 9. Van Dyke DL, Werner L, Rassenti LZ, Neuberg D, Ghia E, Heerema NA, et al. The Dohner fluorescence in situ hybridization prognostic classification of chronic lymphocytic leukaemia (CLL): the CLL Research Consortium experience. Br J Haematol 2016; 173(1): 105-13. google scholar
  • 10. Roos-Weil D, Nguyen-Khac F, Chevret S, Touzeau C, Roux C, Lejeune J, et al. FILO working group. Mutational and cytogenetic analyses of 188 CLL patients with trisomy 12: A retrospective study from the French Innovative Leukemia Organization (FILO) working group. Genes Chromosomes Cancer 2018; 57(11): 533-40. google scholar
  • 11. Puiggros A, Blanco G, Espinet B. Genetic abnormalities in chronic lymphocytic leukemia: where we are and where we go. Biomed Res Int 2014; 2014: 435983. google scholar
  • 12. Strati P, Abruzzo LV, Wierda WG, O'Brien S, Ferrajoli A, Keating MJ. Second cancers and Richter transformation are the leading causes of death in patients with trisomy 12 chronic lymphocytic leukemia. Clin Lymphoma Myeloma Leuk 2015; 15(7): 420-27. google scholar
  • 13. Del Giudice I, Rossi D, Chiaretti S, Marinelli M, Tavolaro S, Gabrielli S, et al. NOTCH1 mutations in +12 chronic lymphocytic leukemia (CLL) confer an unfavorable prognosis, induce a distinctive transcriptional profiling and refine the intermediate prognosis of +12 CLL. Haematologica 2012; 97(3): 437-41. google scholar
  • 14. Van Dyke DL, Shanafelt TD, Call TG, Zent CS, Smoley SA, Rabe KG, et al. A comprehensive evaluation of the prognostic significance of 13q deletions in patients with B-chronic lymphocytic leukaemia. Br J Haematol 2010; 148(4): 544-50. google scholar
  • 15. Stankovic T, Skowronska A. The role of ATM mutations and 11q deletions in disease progression in chronic lymphocytic leukemia. Leuk Lymphoma 2014; 55(6): 1227-39. google scholar
  • 16. De Viron E, Michaux L, Put N, Bontemps F, Van Den Neste E. Present status and perspectives in functional analysis of p53 in chronic lymphocytic leukemia. Leuk Lymphoma 2012; 53(8): 1445-51. google scholar
  • 17. Te Raa GD, Kater AP. TP53 dysfunction in CLL: Implications for prognosis and treatment. Best Pract Res Clin Haematol 2016; 29(1): 90-9. google scholar
  • 18. Kwok M, Agathanggelou A, Davies N, Stankovic T. Targeting the p53 pathway in CLL: state of the art and future perspectives. Cancers (Basel) 2021; 13(18): 4681. google scholar
  • 19. Malcikova J, Smardova J, Rocnova L, Tichy B, Kuglik P, Vranova V, et al. Monoallelic and biallelic inactivation of TP53 gene in chronic lymphocytic leukemia: selection, impact on survival, and response to DNA damage. Blood 2009; 114(26): 5307-14. google scholar
  • 20. Catherwood MA, Gonzalez D, Donaldson D, Clifford R, Mills K, Thornton P. Relevance of TP53 for CLL diagnostics. J Clin Pathol 2019; 72(5): 343-46. google scholar
  • 21. Cuneo A, Rigolin GM, Bigoni R, De Angeli C, Veronese A, Cavazzini F, et al. Chronic lymphocytic leukemia with 6q- shows distinct hematological features and intermediate prognosis. Leukemia 2004; 18(3): 476-83. google scholar
  • 22. Audil HY, Hampel PJ, Van Dyke DL, Achenbach SJ, Rabe KG, Smoley SA, et al. The prognostic significance of del6q23 in chronic lymphocytic leukemia. Am J Hematol 2021; 96(6): E203-E206. google scholar
  • 23. Jarosova M, Hruba M, Oltova A, Plevova K, Kruzova L, Kriegova E, et al. Chromosome 6q deletion correlates with poor prognosis and low relative expression of FOXO3 in chronic lymphocytic leukemia patients. Am J Hematol 2017; 92(10): E604-E607. google scholar
  • 24. Qiu HX, Xu W, Cao XS, Zhou M, Shen YF, Xu YL, et al. Cytogenetic characterisation in Chinese patients with chronic lymphocytic leukemia: a prospective, multicenter study on 143 cases analysed with interphase fluorescence in situ hybridisation. Leuk Lymphoma 2008; 49(10): 1887-92. google scholar
  • 25. Wang DM, Miao KR, Fan L, Qiu HR, Fang C, Zhu DX, et al. Intermediate prognosis of 6q deletion in chronic lymphocytic leukemia. Leuk Lymphoma 2011; 52(2): 230-37. google scholar
  • 26. Cavazzini F, Ciccone M, Negrini M, Rigolin GM, Cuneo A. Clinicobiologic importance of cytogenetic lesions in chronic lymphocytic leukemia. Expert Rev Hematol 2009; 2(3): 305-14. google scholar
  • 27. Davids MS, Vartanov A, Werner L, Neuberg D, Dal Cin P, Brown JR. Controversial fluorescence in situ hybridization cytogenetic abnormalities in chronic lymphocytic leukaemia: new insights from a large cohort. Br J Haematol 2015; 170(5): 694-703. google scholar
  • 28. Montserrat E, Bauman T, Delgado J. Present and future of personalized medicine in CLL. Best Pract Res Clin Haematol 2016; 29(1): 100-10. google scholar
  • 29. Wan Mohamad Zamri WN, Mohd Yunus N, Abdul Aziz AA, Zulkipli NN, Sulong S. Perspectives on the application of cytogenomic approaches in chronic lymphocytic leukaemia. diagnostics (Basel) 2023; 13(5): 964. google scholar
  • 30. Strati P, Parikh SA, Chaffee KG, Kay NE, Call TG, Achenbach SJ, et al. Relationship between co-morbidities at diagnosis, survival and ultimate cause of death in patients with chronic lymphocytic leukaemia (CLL): a prospective cohort study. Br J Haematol 2017; 178(3): 394-402. google scholar
There are 30 citations in total.

Details

Primary Language English
Subjects Clinical Sciences (Other)
Journal Section Research Article
Authors

Ayşe Gül Bayrak Tokaç 0000-0003-2228-0632

Simge Erdem 0000-0001-8095-5445

Gülçin Bağatır 0000-0002-4685-6686

Ender Coşkunpınar 0000-0002-1003-5544

Kübra Gündüz 0000-0003-0824-2357

Okan Cetın 0000-0003-1672-4743

Abdullah Savaş 0009-0008-5221-0938

Mustafa Nuri Yenerel 0000-0002-6473-1342

Şükrü Palanduz 0000-0002-9435-009X

Publication Date August 29, 2025
Submission Date March 19, 2025
Acceptance Date July 16, 2025
Published in Issue Year 2025 Volume: 15 Issue: 2

Cite

Vancouver Bayrak Tokaç AG, Erdem S, Bağatır G, Coşkunpınar E, Gündüz K, Cetın O, et al. Clinical Significance of Cytogenetic Abnormalities Detected by FISH in CLL: Insights from a Real-World Single-Centre Cohort. Experimed. 2025;15(2):135-44.