Clinical and molecular characteristics and treatment patterns of adolescent and young adult patients with chronic lymphocytic leukaemia.
Abnormal Karyotype
Adolescent
Adult
Allografts
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Combined Modality Therapy
Disease-Free Survival
Female
Hematopoietic Stem Cell Transplantation
Humans
Kaplan-Meier Estimate
Leukemia, Lymphocytic, Chronic, B-Cell
/ drug therapy
Lymphoma, B-Cell
/ epidemiology
Male
Neoplasms, Second Primary
/ epidemiology
Retrospective Studies
Syndrome
Young Adult
CLL FISH
IGHV
adolescent and young adult
chronic lymphocytic leukaemia
novel oral targeted therapy
prognostic factors
Journal
British journal of haematology
ISSN: 1365-2141
Titre abrégé: Br J Haematol
Pays: England
ID NLM: 0372544
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
revised:
25
03
2021
received:
19
01
2021
accepted:
29
03
2021
pubmed:
12
5
2021
medline:
17
12
2021
entrez:
11
5
2021
Statut:
ppublish
Résumé
Chronic lymphocytic leukaemia (CLL) rarely presents in adolescent and young adult (AYA) patients (patients aged 15-39 years). Disease characteristics and outcomes of AYA patients with CLL are not well understood, particularly in the era of novel oral targeted therapies. We analysed outcomes of 227 AYA patients with CLL diagnosed in the last two decades and evaluated at our institution. Median time to first treatment (TTFT) was 2·2 years, and five- and 10-year overall survival (OS) were 90% and 78%, respectively. Pre-treatment elevated beta 2-microglobulin, advanced Rai stage, del(11q) or del(17p) by FISH, unmutated IGHV and CD38 positivity were associated with both shorter TTFT and OS. Within the subgroup of patients who received oral targeted therapy at any time, del(11q) or del(17p) and complex karyotype were associated with shorter OS. First-line treatment choice was significantly associated with time to second treatment (P < 0·001). Patients harbouring del(11q) or del(17p) experienced shorter time to Richter transformation and were more likely to undergo an allogeneic stem cell transplant. There was a significant association between age and both OS and time to Richter transformation. Our study is the first analysis of AYA patients with CLL with a large number of patients treated with oral targeted therapies.
Identifiants
pubmed: 33973230
doi: 10.1111/bjh.17498
pmc: PMC9284944
mid: NIHMS1703741
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
61-68Subventions
Organisme : NCI NIH HHS
ID : P30 CA016672
Pays : United States
Informations de copyright
© 2021 British Society for Haematology and John Wiley & Sons Ltd.
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