CLL Coverage from Every Angle

IGHV Mutations and the Relationship Between Translocation and Time to Treatment in CLL

By: Kayci Reyer
Posted: Tuesday, July 28, 2020

Mutations of the immunoglobulin heavy chain variable (IGHV) variable regional appear to be associated with favorable prognoses in patients with chronic lymphocytic leukemia (CLL), but that association may be negated by the presence of a translocation, according to research published in Haematologica. However, Nyla A. Heerema, MD, of The Ohio State University Wexner Medical Center, and colleagues found the presence of a translocation did not have the same effect in patients without IGHV mutations.

The study included 329 patients with CLL who had not yet undergone treatment, 85 (25.8%) of whom had a translocation. Another 53 patients (16.1%) had a complex karyotype. The median time to first treatment was 47 months. According to univariable analyses, patients were more likely to experience a shorter time to first treatment if they had Rai stage 3 or 4 disease; beta2-microglobulin of more than 3.5 mg/L; log-transformed white blood cells; unmutated IGHV; a complex karyotype; a translocation; and/or fluorescence in situ hybridization indicating trisomy 8, del(11q), and del(17p).

A multivariable analysis revealed that a patient’s IGHV mutation status had a significant effect on the relationship between translocation and time to first treatment. The investigators reported that patients with an IGHV mutation who had a translocation were 3.5 times more likely to start treatment than were patients who did not have a translocation, a risk disparity that was not reflected in patients without an IGHV mutation.

Disclosure: The study authors reported no conflicts of interest.

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