Major changes or additions to new guidelines for chronic lymphocytic leukemia include the following:
Molecular genetics: Recognition of the clinical importance of specific genomic alterations/mutations 17p deletion and mutations in TP53 on therapeutic response.
IGHV mutational status: Immunoglobulin variable heavy chain (IGHV) genes offer important prognostic information.
Biomarkers: Soluble CD23, thymidine kinase, and beta-2-microglobulin need to be standardized and used in prospective clinical trials.
MRD: Minimal residual disease should be assessed in clinical trials aimed at maximizing remission depth.
Antiviral prophylaxis: Patients should be tested for HBV serological status before starting on an anti-CD20 agent.
Hallek M et al. Blood https://doi.org/10.1182/blood-2017-09-806398
This Week's Must Reads
Must Reads in CLL
Uninterrupted ibrutinib with CAR T may boost outcomes in CLL , Gauthier J et al. ASH 2018, Abstract 299
The role of PTPN22 R620W in CLL, Leukemia & Lymphoma 2018
Ibrutinib dosing changes and the impact on survival, Williams AM et al. Clin Lymphoma Myeloma Leuk. 2018 Oct 12. doi: 10.1016/j.clml.2018.10.005
Long-term ibrutinib data in older patients, Barr PM et al. Haematologica. 2018;103(9):1502-10