Contributions
Type: Publication Only
Background
Genetic aberrations detected by fluorescence in situ hybridization (FISH) and cytogenetic (CG) testing provide important prognostic information for CLL pts. The identification of genetic abnormalities has particular relevance in choosing immunochemo- or kinase inhibitor therapies, allogeneic stem cell transplantation, or clinical trials for CLL pts.
Aims
To analyze factors influencing decisions to perform FISH or CG testing in CLL pts.
Methods
Connect® CLL is a large, prospective, longitudinal, multicenter, observational registry of 1494 CLL pts at 179 community (1311 pts), 17 academic (155 pts), and 3 government (28 pts) sites. Pts were enrolled within 2 months of initiating any line of CLL-directed therapy (LOT). Univariate (UV) and multivariate (MV) logistic regression analyses were conducted to identify characteristics associated with a decision to perform genetic testing at LOT 1 and at LOT ≥ 2.
Results
Baseline characteristics for the cohort were as follows: 63.8% of pts were male and the median age was 69 years (range 22–99). The median time from diagnosis to inclusion in the registry was 3.7 years (range 0–32) and 92.7% of pts had an ECOG PS score of ≤ 1. FISH or CG was performed at study enrollment in 861/1494 (58%) pts (36% CG, 49% FISH, 28% both). 65% of 889 pts were tested for FISH/CG prior to LOT1, 50% of 260 in LOT2, 45% of 345 in LOT>3. Of 861 pts tested at enrollment, 29% had FISH/CG retested with a subsequent LOT. In UV analyses (14 predictors), FISH/CG were more often performed at academic sites (p 0.005), in pts age ≤75 (p 0.0002), at enrollment at LOT1 vs. LOT ≥2 (p < 0.0001), in private insurance pts (p 0.002) and Rai stage ≥2 (p < 0.0001). Table 1 describes independent predictors of performing genetic FISH/CG testing stratified by LOT (LOT1 vs. LOT≥2) and practice setting (all practice settings vs. community-government settings only).
Summary
Our results indicate that only a fraction of CLL pts are tested/re-tested for genetic alterations by FISH/CG. Given the significance of identifying del17p or complex CG in selecting each LOT, these results indicate a need for increased awareness of the importance of this testing in clinical practice.
Keyword(s): Chronic lymphocytic leukemia, Cytogenetics, FISH, Prognostic factor
Session topic: Publication Only
Type: Publication Only
Background
Genetic aberrations detected by fluorescence in situ hybridization (FISH) and cytogenetic (CG) testing provide important prognostic information for CLL pts. The identification of genetic abnormalities has particular relevance in choosing immunochemo- or kinase inhibitor therapies, allogeneic stem cell transplantation, or clinical trials for CLL pts.
Aims
To analyze factors influencing decisions to perform FISH or CG testing in CLL pts.
Methods
Connect® CLL is a large, prospective, longitudinal, multicenter, observational registry of 1494 CLL pts at 179 community (1311 pts), 17 academic (155 pts), and 3 government (28 pts) sites. Pts were enrolled within 2 months of initiating any line of CLL-directed therapy (LOT). Univariate (UV) and multivariate (MV) logistic regression analyses were conducted to identify characteristics associated with a decision to perform genetic testing at LOT 1 and at LOT ≥ 2.
Results
Baseline characteristics for the cohort were as follows: 63.8% of pts were male and the median age was 69 years (range 22–99). The median time from diagnosis to inclusion in the registry was 3.7 years (range 0–32) and 92.7% of pts had an ECOG PS score of ≤ 1. FISH or CG was performed at study enrollment in 861/1494 (58%) pts (36% CG, 49% FISH, 28% both). 65% of 889 pts were tested for FISH/CG prior to LOT1, 50% of 260 in LOT2, 45% of 345 in LOT>3. Of 861 pts tested at enrollment, 29% had FISH/CG retested with a subsequent LOT. In UV analyses (14 predictors), FISH/CG were more often performed at academic sites (p 0.005), in pts age ≤75 (p 0.0002), at enrollment at LOT1 vs. LOT ≥2 (p < 0.0001), in private insurance pts (p 0.002) and Rai stage ≥2 (p < 0.0001). Table 1 describes independent predictors of performing genetic FISH/CG testing stratified by LOT (LOT1 vs. LOT≥2) and practice setting (all practice settings vs. community-government settings only).
Summary
Our results indicate that only a fraction of CLL pts are tested/re-tested for genetic alterations by FISH/CG. Given the significance of identifying del17p or complex CG in selecting each LOT, these results indicate a need for increased awareness of the importance of this testing in clinical practice.
Keyword(s): Chronic lymphocytic leukemia, Cytogenetics, FISH, Prognostic factor
Session topic: Publication Only