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Jennifer R. Brown, MD, PhD


Prognostic Value of Epigenetic Classification System in Patients With CLL

By: Julia Fiederlein
Posted: Monday, March 28, 2022

Previous studies have identified five CpG sites that may classify patients with chronic lymphocytic leukemia (CLL) into three prognostic subgroups. Christina Grimm, PhD, of the University of Cologne, Germany, and colleagues conducted a study to validate this epigenetic marker set in an additional cohort. The results, which were published in Biomarker Insights, support its prognostic value for patient stratification in routine clinical diagnostics.

“The epigenetic classification system consisting of five markers has the potential to be clinically used since it is relatively easy to apply,” the investigators remarked. “Required steps are isolation of genomic DNA, bisulfite treatment (or enzymatic conversion) of genomic DNA, polymerase chain reaction using one biotinylated primer and pyrosequencing, and a straightforward bioinformatics analysis.”

A total of 28, 10, and 41 German patients were classified into the naive B-cell–like CLL, intermediate CLL, and memory B-cell–like CLL subgroups, respectively. According to the investigators, epigenetic grouping was associated with IGHV mutational status, isolated del13q, del17p, complex karyotype, variable heavy chain usage, time to first treatment, and overall survival.

Based on the results of multivariate Cox regression analysis, naive B-cell–like CLL seems to be a factor for earlier treatment (hazard ratio = 6.3; P = .0002) compared with IGHV mutational status (hazard ratio = 4.6; P = .0008). Kaplan-Meier estimation revealed that the epigenetic classification system performed better than IGHV classification; additionally, epigenetic classification allowed for the introduction of the intermediate CLL group.

Disclosure: For full disclosures of the study authors, visit

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