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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Friday, March 4, 2022
For patients with Richter transformation from chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL), chromosomal microarray analysis may provide important prognostic information to influence clinical decisions like stem cell transplantation consolidation, according to findings presented in Cancer Genetics. Daynna J. Wolff, PhD, of the Medical University of South Carolina, Charleston, and colleagues concluded that risk stratification by chromosomal microarray analysis may justify closer observation of patients, lead to more frequent imaging assessments, and perhaps promote preemptive therapy.
“Despite increasingly effective and well-tolerated therapies for CLL, Richter transformation prevalence has not decreased,” the authors commented. “[Chromosomal microarray analysis] has the capability to provide information of prognostic and therapeutic significance with a single test that may obviate the need for send-out testing of multiple samples.”
In this study, the authors conducted a retrospective analysis of 670 patients with CLL or SLL from 2010 to 2019. Of those patients, 24 (3.5%) developed Richter transformation. Among that group, seven received chromosomal microarray analysis on both the Richter transformation and CLL samples.
Chromosomal microarray analysis revealed that six patients (86%) had common aberrations between the CLL and Richter’s transformation samples, suggesting evidence of common clonality. The procedure also helped establish other prognostic factors for transformation, as five patients (71%) exhibited TP53 loss in the Richter transformation clone. Loss of TP53 function is seen as an independent predictor of overall survival after transformation, the authors noted.
Chromosomal microarray analysis also revealed genomic complexity in four of the CLL samples and seven of the Richter transformation samples, which is consistent with clonal evolution in the majority of Richter transformation cases.
Disclosure: For a full disclosure of the study authors, visit cancergeneticsjournal.org.
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