Clonal Evolution in Chronic Lymphocytic Leukemia

Cytogenetic abnormalities detected by FISH are present in most chronic CLL patients at the time of diagnosis, and are predictive of overall survival and clonal evolution; acquisition of new abnormalities can occur during the disease course.

Clonal lymphocytic leukemia (CLL) is a highly heterogeneous disease, with clinically relevant biologic and prognostic subgroups that are defined by cytogenetic and phenotypic markers. The results of past retrospective studies have shown a strong correlation of overall survival (OS) with specific cytogenetic markers, as determined by fluorescent in situ hybridization (FISH) analysis. Mayo Clinic researchers used FISH to prospectively analyze 159 previously untreated CLL patients and correlated these findings with expression of the protein ZAP-70 and OS. Importantly, they also evaluated FISH analysis temporally for evidence of clonal evolution.

Most patients underwent initial studies within 1 year of diagnosis (median, 3.4 months). Eighty-thre…

Reviewing Author

Michael E. Williams, MD

Clonal Evolution in Chronic Lymphocytic Leukemia

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Reviewing Author