12th Congress of the European Hematology ... - Haematologica

patients. After a median follow-up of 65 months (range 32-76), all
patients have relapsed. The median time free from disease was 16
months (range: 3-46). A second-line therapy has been required by 12
patients (63%), with a median time to the next treatment of 29.5 months
(range: 15-68). Rituximab infusion was well tolerated; mild infusionrelated
side effects were observed in 3 cases. No patient showed hematologic
toxicity or infection. Conclusions. The results of this study indicate
that Rituximab, given as post-remissional therapy in older CLL
patients treated with CP, produced a clinical benefit with a good safety
profile in the majority of cases. Additional studies need to be designed
to explore new Rituximab schedules, the association of Rituximab with
C and post-remissional treatment strategies in CLL patients not eligible
for aggressive treatment modalities.
0125
COMBINATION OF IGVH MUTATIONAL STATUS AND GENETIC ABNORMALITIES MAY
FURTHER REFINE PROGNOSTIC STRATIFICATION IN PATIENTS WITH CHRONIC
LYMPHOCYTIC LEUKEMIA
L. Smolej, 1 M. Hrudkova, 1 P. Zak, 1D. Belada, 1 S. Pekova, 2 L. Kucerova, 1
J. Schwarz, 3 J. Sobotka, 4 V. Holubova4 1 University Hospital and Medical School, HRADEC KRALOVE; 2 Na Homolce
Hospital, PRAGUE; 3 Institute of Hematology and Transfusion, PRAGUE; 4 J.G.
Mendel Memorial Oncology Institute, NOVY JICIN, Czech Republic
Introduction. Chronic lymphocytic leukemia (CLL) is a disease with an
extremely variable clinical course. New prognostic factors such as mutation
status of immunoglobulin heavy chain variable region (IgVH) or
genetic aberrations detected by fluorescent in situ hybridization (FISH)
can identify patients with high risk disease. However, a single prognostic
factor is not sufficient to assess the prognosis of an individual patient
accurately enough. Aims. To assess the prognostic impact of combination
of IgVH mutational status and genetic aberrations in a single-center CLL
cohort. Methods. 91 patients with CLL diagnosed according to NCI-WG
criteria were included in the study. IgVH mutation status was analyzed
using cDNA transcribed from B-CLL RNA for touch-down reverse transcriptase
polymerase chain reaction (RT-PCR) with degenerate primers
for VH1-7 families; IgVH sequences were aligned to the nearest germline
using the Ig BLAST database. Forty-two patients carried mutated IgVH
and 49 unmutated IgVH genes. Genetic aberrations were detected using
commercially available FISH kits for del 13q, del 11q, del 17, and trisomy
12 by Abbott. There were 33 cases with del 13q as a sole abormality, 25
patients with del11q, 18 with trisomy 12 and 14 patients with del17p.
More than 2 abnormalities were detected in 14 cases.
Figure 1. Combination of IgVH and FISH and PFS.
Results. As expected, patients with unmutated IgVH had significantly
shorter PFS in comparison to mutated IgVH genes (median PFS 15 vs. 101
months, p