From Biomarkers to Models in the Changing Landscape of Chronic Lymphocytic Leukemia: Evolve or Become Extinct

• Published in: Cancers Vol. 13; no. 8; p. 1782
• Main Authors: González-Gascón-Y-Marín, Isabel, Muñoz-Novas, Carolina, Rodríguez-Vicente, Ana-Eugenia, Quijada-Álamo, Miguel, Hernández-Sánchez, María, Pérez-Carretero, Claudia, Ramos-Ascanio, Victoria, Hernández-Rivas, José-Ángel
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08.04.2021; MDPI
• Subjects: Algorithms; Biomarkers; Chronic lymphocytic leukemia; Clinical decision making; Clinical trials; Gene deletion; Genes; Karyotypes; Leukemia; Lymphatic leukemia; Medical prognosis; Mutation; p53 Protein; Patients; Quality of life; Review; targeted therapy; prognosis; chronic lymphocytic leukemia
• ISSN: 2072-6694; 2072-6694
• DOI: 10.3390/cancers13081782

Chronic lymphocytic leukemia (CLL) is an extremely heterogeneous disease. With the advent of oral targeted agents (Tas) the treatment of CLL has undergone a revolution, which has been accompanied by an improvement in patient's survival and quality of life. This paradigm shift also affects the value of prognostic and predictive biomarkers and prognostic models, most of them inherited from the chemoimmunotherapy era but with a different behavior with Tas. This review discusses: (i) the role of the most relevant prognostic and predictive biomarkers in the setting of Tas; and (ii) the validity of classic and new scoring systems in the context of Tas. In addition, a critical point of view about predictive biomarkers with special emphasis on 11q deletion, novel resistance mutations, TP53 abnormalities, IGHV mutational status, complex karyotype and mutations is stated. We also go over prognostic models in early stage CLL such as IPS-E. Finally, we provide an overview of the applicability of the CLL-IPI for patients treated with Tas, as well as the emergence of new models, generated with data from patients treated with Tas.