Chronic Lymphocytic Leukemia With Deletion 17 p : Emerging Treatment Options November 15

Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults in the United States, with more than 16,000 people expected to be diagnosed with CLL in 2012. Most patients with CLL do not require treatment at diagnosis. Various genetic/molecular markers to help with prognostication have been established and validated and are routinely used in clinical practice.[1] These include β2-microglobulin, cytogenetics, immunoglobulin variable heavy chain (IGVH) mutational status, Zeta chain−associated protein 70 (ZAP-70) expression, and CD38 expression. The presence of deletion 17p, assessed either by conventional cytogenetics or, more commonly, by interphase fluorescent in situ hybridization (FISH), is associated with the worst clinical outcomes in patients with CLL.[2] In the current issue of ONCOLOGY, Drs. Stephens and Byrd provide a comprehensive overview of the issues pertaining to the management of patients with CLL associated with deletion 17p.

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[2]  A. Pettitt,et al.  Alemtuzumab in combination with methylprednisolone is a highly effective induction regimen for patients with chronic lymphocytic leukemia and deletion of TP53: final results of the national cancer research institute CLL206 trial. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[3]  J. Byrd,et al.  The Bruton's Tyrosine Kinase (BTK) Inhibitor PCI-32765 Induces Durable Responses in Relapsed or Refractory (R/R) Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLL/SLL): Follow-up of a Phase Ib/II Study , 2011 .

[4]  G. Morgan,et al.  Mutational status of the TP53 gene as a predictor of response and survival in patients with chronic lymphocytic leukemia: results from the LRF CLL4 trial. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[5]  J. Gribben,et al.  Update on therapy of chronic lymphocytic leukemia. , 2011, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  A. Berrebi,et al.  Addition of rituximab to fludarabine and cyclophosphamide in patients with chronic lymphocytic leukaemia: a randomised, open-label, phase 3 trial , 2010, The Lancet.

[7]  Susan O'Brien,et al.  De novo deletion 17p13.1 chronic lymphocytic leukemia shows significant clinical heterogeneity: the M. D. Anderson and Mayo Clinic experience. , 2008, Blood.

[8]  M J S Dyer,et al.  A subset of Binet stage A CLL patients with TP53 abnormalities and mutated IGHV genes have stable disease , 2009, Leukemia.

[9]  K. Do,et al.  Long-term results of the fludarabine, cyclophosphamide, and rituximab regimen as initial therapy of chronic lymphocytic leukemia. , 2008, Blood.

[10]  T. Robak,et al.  Alemtuzumab compared with chlorambucil as first-line therapy for chronic lymphocytic leukemia. , 2007, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.