SOHO State of the Art Updates and Next Questions: Clonal Evolution in Chronic Lymphocytic Leukemia |
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| Affiliation: | 1. European Society for Medical Oncology (ESMO), Lugano, Switzerland;2. Ludwig Boltzmann Institute for Applied Cancer Research (LBI-ACR VIEnna)–LB Cluster Translational Oncology, Centre for Oncology and Haematology, Kaiser Franz Josef-Spital, Vienna, Austria;3. European Organisation for Research and Treatment of Cancer (EORTC), Brussels;4. International Regulatory and Intergroup Office, EORTC Headquarters, Brussels, Belgium;5. Department of Cancer Medicine, Istituto Nazionale Tumori, Milan, Italy |
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| Abstract: | Chronic lymphocytic leukemia (CLL) is an indolent disease with a long-lasting clinical course, with indication for treatment only when symptomatic. Its clinical heterogeneity is widely reported, with some patients requiring treatment soon after diagnosis because of development of cytopenia or bulky lymphadenopathy, and others showing a stable or a slowly progressive disease not requiring treatment for decades. Longitudinal sampling of peripheral blood, with accessible tumor cells and circulating tumor DNA, enabled the analysis of disease growing dynamics and the characterization of clonal evolution. Here we describe the main known features of CLL genomics and its shaping upon treatment, which can lead to progression, treatment refractoriness, or transformation into an aggressive lymphoma. |
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| Keywords: | CLL Clonal dynamics Genetics Mutations Resistance |
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