PMID- 29352719 OWN - NLM STAT- MEDLINE DCOM- 20190225 LR - 20191210 IS - 2152-2669 (Electronic) IS - 2152-2669 (Linking) VI - 18 IP - 2 DP - 2018 Feb TI - Prognostic Testing Patterns and Outcomes of Chronic Lymphocytic Leukemia Patients Stratified by Fluorescence In Situ Hybridization/Cytogenetics: A Real-world Clinical Experience in the Connect CLL Registry. PG - 114-124.e2 LID - S2152-2650(17)31539-2 [pii] LID - 10.1016/j.clml.2017.11.010 [doi] AB - INTRODUCTION: Prognostic genetic testing is recommended for patients with chronic lymphocytic leukemia (CLL) to guide clinical management. Specific abnormalities, such as del(17p), del(11q), and unmutated IgHV, can predict the depth and durability of the response to CLL therapy. PATIENTS AND METHODS: In the present analysis of the Connect CLL Registry (ClinicalTrials.gov identifier, NCT01081015), a prospective observational cohort study of patients treated across 199 centers, the patterns of prognostic testing and outcomes of patients with unfavorable-risk genetics were analyzed. From 2010 to 2014, 1494 treated patients were enrolled in the registry by line of therapy (LOT), and stratified by the results of cytogenetic/fluorescence in situ hybridization (FISH) testing into 3 risk levels: unfavorable (presence of del[17p] or del[11q]), favorable (absence of del[17p] and del[11q]), and unknown. RESULTS: Cytogenetic/FISH testing was performed in 861 patients (58%) at enrollment; only 40% of these patients were retested before starting a subsequent LOT. Of those enrolled at the first LOT, unfavorable-risk patients had inferior event-free survival compared with favorable-risk patients (hazard ratio, 1.60; P = .001). Event-free survival was inferior with bendamustine-containing regimens (P < .0001). Event-free survival did not differ significantly between risk groups for patients treated with ibrutinib or idelalisib in the relapse/refractory setting. The predictors of reduced event-free survival included unfavorable-risk genetics, age >/= 75 years, race, and treatment choice at enrollment. CONCLUSION: The present study has shown that prognostic cytogenetic/FISH testing is infrequently performed and that patients with unfavorable-risk genetics treated with immunochemotherapy combinations have worse outcomes. This underscores the importance of performing prognostic genetic testing for all CLL patients to guide treatment. CI - Copyright (c) 2017 The Authors. Published by Elsevier Inc. All rights reserved. FAU - Mato, Anthony AU - Mato A AD - Center for CLL, Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA. Electronic address: Anthony.Mato@uphs.upenn.edu. FAU - Nabhan, Chadi AU - Nabhan C AD - Cardinal Health, Dublin, OH. FAU - Kay, Neil E AU - Kay NE AD - Division of Hematology, Mayo Clinic, Rochester, MN. FAU - Lamanna, Nicole AU - Lamanna N AD - Division of Hematology and Oncology, Department of Medicine, New York-Presbyterian/Columbia University Medical Center, New York, NY. FAU - Kipps, Thomas J AU - Kipps TJ AD - Moores Cancer Center, UC San Diego Health, La Jolla, CA. FAU - Grinblatt, David L AU - Grinblatt DL AD - NorthShore University HealthSystem, Evanston, IL. FAU - Flowers, Christopher R AU - Flowers CR AD - Emory University, Atlanta, GA. FAU - Farber, Charles M AU - Farber CM AD - Summit Medical Group, MD Anderson Cancer Center, Morristown, NJ. FAU - Davids, Matthew S AU - Davids MS AD - Dana-Farber Cancer Institute, Boston, MA. FAU - Kiselev, Pavel AU - Kiselev P AD - Celgene Corporation, Summit, NJ. FAU - Swern, Arlene S AU - Swern AS AD - Celgene Corporation, Summit, NJ. FAU - Bhushan, Shriya AU - Bhushan S AD - Celgene Corporation, Summit, NJ. FAU - Sullivan, Kristen AU - Sullivan K AD - Celgene Corporation, Overland Park, KS. FAU - Flick, E Dawn AU - Flick ED AD - Celgene Corporation, San Francisco, CA. FAU - Sharman, Jeff P AU - Sharman JP AD - Willamette Valley Cancer Institute, US Oncology, Springfield, OR. LA - eng SI - ClinicalTrials.gov/NCT01081015 PT - Clinical Trial PT - Journal Article PT - Multicenter Study PT - Observational Study PT - Research Support, Non-U.S. Gov't DEP - 20171206 PL - United States TA - Clin Lymphoma Myeloma Leuk JT - Clinical lymphoma, myeloma & leukemia JID - 101525386 RN - 0 (Immunoglobulin Heavy Chains) RN - 0 (Immunoglobulin Variable Region) SB - IM MH - Adult MH - Aged MH - Aged, 80 and over MH - Antineoplastic Combined Chemotherapy Protocols/*therapeutic use MH - Chromosome Deletion MH - Cytogenetics/*methods MH - Female MH - Humans MH - Immunoglobulin Heavy Chains/genetics MH - Immunoglobulin Variable Region/genetics MH - In Situ Hybridization, Fluorescence/*methods MH - Kaplan-Meier Estimate MH - Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis/*drug therapy/genetics MH - Male MH - Middle Aged MH - Outcome Assessment, Health Care/methods/statistics & numerical data MH - Prognosis MH - Prospective Studies MH - Registries MH - Young Adult OTO - NOTNLM OT - Community setting OT - Cytogenetic testing OT - Kinase inhibitor OT - Prognosis OT - Unfavorable risk EDAT- 2018/01/21 06:00 MHDA- 2019/02/26 06:00 CRDT- 2018/01/21 06:00 PHST- 2017/09/08 00:00 [received] PHST- 2017/11/22 00:00 [revised] PHST- 2017/11/28 00:00 [accepted] PHST- 2018/01/21 06:00 [pubmed] PHST- 2019/02/26 06:00 [medline] PHST- 2018/01/21 06:00 [entrez] AID - S2152-2650(17)31539-2 [pii] AID - 10.1016/j.clml.2017.11.010 [doi] PST - ppublish SO - Clin Lymphoma Myeloma Leuk. 2018 Feb;18(2):114-124.e2. doi: 10.1016/j.clml.2017.11.010. Epub 2017 Dec 6.