LB08 - Secondary factors in chronic lymphocytic leukemia (CLL) such as COBBLL1 and response prediction in TP53 non-mutant cohort treated with single agent venetoclax or Obinutuzumab
Consultant hematology/oncology Al Bairouni University Cancer Center Damascus, Dimashq, Syria
Background: Chronic lymphocytic leukemia (CLL) new approach and treatment depend on risk stratification through a study of several genes implicated in its evolution. Genes are TP53, IGHV,BCL-2 family, LPL, COBBLL1 and some CDs such as ZAP 70. Treatment options depend on the previous findings.
Aims: To evaluate the impact of genetic findings in CLL newly diagnosed low risk patients treated with single agent Obinutuzumab or Venetoclax in terms of response rate.
Methods: We studied prospectively 26 newly diagnosed patients with CLL. All of them were well fit for treatment. All patients had TP53 non-mutated protein and mutated IGHV.LPL was weakly expressed in 7 patients, ZAP 70 weakly expressed in 10 patients while COBBLL1 was highly expressed in 10 patients. 5 patients showed 13q14.3 deletion.
Results: Response rate in term of normalization of white blood cell count was variable among patients. Response was very slow ad unremarkable during the first 2 months of treatment in those showing COBBLL1 high expression (p value .04) while the response was more rapid in those with low expression of both LPL and ZAP 70 (p value .03). 13q14.3 deletion was not correlated with response to treatment (p value .06). toxicity profile was not correlated with any genetic or chromosomal defect (p value .05). Summary/
Conclusion: COBBLL1 Can be used with a cumulative data as a factor predicting response to treatment in newly diagnosed TP53 non-mutated and IGVH mutated CLL patients.
