%0 Journal Article
%A Hernández Rivas, José Ángel
%A Hernández Sánchez, María
%A Rodríguez Vicente, Ana Eugenia
%A Grossmann, Vera
%A Collado, Rosa
%A Heras, Cecilia 
%A Puiggros, Anna
%A Martín, Ana África
%A Puig, Noemí
%A Benito, Rocío
%A Robledo, Cristina
%A Delgado, Julio
%A González, Teresa
%A Queizán, José Antonio
%A Galende, Josefina
%A Fuente, Ignacio De La
%A Martín-Núñez, Guillermo
%A Alonso, José María
%A Abrisqueta, Pau
%A Luño, Elisa
%A Marugán, Isabel
%A González Gascón, Isabel
%A Bosch, Francesc
%A Kohlmann, Alexander
%A González, Marcos
%A Espinet, Blanca
%A Hernández Rivas, Jesús María
%T A Low Frequency of Losses in 11q Chromosome Is Associated with Better Outcome and Lower Rate of Genomic Mutations in Patients with Chronic Lymphocytic Leukemia
%D 2015
%U https://hdl.handle.net/20.500.14352/93297
%X To analyze the impact of the 11q deleted (11q-) cells in CLL patients on the time to first therapy (TFT) and overall survival (OS), 2,493 patients with CLL were studied. 242 patients (9.7%) had 11q-. Fluorescence in situ hybridization (FISH) studies showed a threshold of 40% of deleted cells to be optimal for showing that clinical differences in terms of TFT and OS within 11q- CLLs. In patients with ≥40% of losses in 11q (11q-H) (74%), the median TFT was 19 months compared with 44 months in CLL patients with <40% del(11q) (11q-L) (P<0.0001). In the multivariate analysis, only the presence of 11q-L, mutated IGHV status, early Binet stage and absence of extended lymphadenopathy were associated with longer TFT. Patients with 11q-H had an OS of 90 months, while in the 11q-L group the OS was not reached (P = 0.008). The absence of splenomegaly (P = 0.02), low LDH (P = 0.018) or β2M (P = 0.006), and the presence of 11q-L (P = 0.003) were associated with a longer OS. In addition, to detect the presence of mutations in the ATM, TP53, NOTCH1, SF3B1, MYD88, FBXW7, XPO1 and BIRC3 genes, a select cohort of CLL patients with losses in 11q was sequenced by next-generation sequencing of amplicons. Eighty % of CLLs with 11q- showed mutations and fewer patients with low frequencies of 11q- had mutations among genes examined (50% vs 94.1%, P = 0.023). In summary, CLL patients with <40% of 11q- had a long TFT and OS that could be associated with the presence of fewer mutated genes.
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