Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region
BACKGROUND: In the last years genomic and somatic alterations have shown to play a pivotal role in the pathogenesis of chronic lymphocytic leukemia (CLL) and new prognostic factors have been identified accordingly. AIM: To describe a real-life diagnostic and therapeutic approach to CLL that takes in...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
SEEd Medical Publishers
2020-02-01
|
| Series: | Farmeconomia: Health Economics and Therapeutic Pathways |
| Subjects: | |
| Online Access: | https://journals.seedmedicalpublishers.com/index.php/FE/article/view/1452 |
| _version_ | 1818609439299600384 |
|---|---|
| author | Monica Bocchia Alberto Bosi Enrico Capochiani Stefania Ciolli Romano Danesi Sara Galimberti Alessandro Gozzetti Sabrina Moretti Ubaldo Occhini Mario Petrini |
| author_facet | Monica Bocchia Alberto Bosi Enrico Capochiani Stefania Ciolli Romano Danesi Sara Galimberti Alessandro Gozzetti Sabrina Moretti Ubaldo Occhini Mario Petrini |
| author_sort | Monica Bocchia |
| collection | DOAJ |
| description | BACKGROUND: In the last years genomic and somatic alterations have shown to play a pivotal role in the pathogenesis of chronic lymphocytic leukemia (CLL) and new prognostic factors have been identified accordingly.
AIM: To describe a real-life diagnostic and therapeutic approach to CLL that takes into account the role of genomic and somatic prognostic factors in the risk stratification of developing progressive disease, and treatment decision.
METHODS: This new proposal has been developed and validated by ten key opinion leaders from Tuscany Region during two Expert Meetings. The approach suggested comes from their experience in daily clinical practice and is supported by guidelines recommendations, clinical trials results, and drugs prescribing conditions in Italy.
RESULTS: Beside TP53 deletion or mutated status, the Expert Panel highlighted the importance of the IGHV mutation status characterization, since the diagnosis, in order to identify patients who will have a more aggressive progression. Furthermore, just before starting treatment, to obtain useful prognostic information and indication in the selection of the therapy, they recommend cytogenetic analysis for the detection of del(11q), trisomy 12, del(13q), del(17p), conventional karyotyping of stimulated CLL cells, TP53 sequencing, and molecular genetic analysis to detect IGHV mutation status.
CONCLUSIONS: The Expert Panel recognized the limitations associated with traditional staging systems in identifying patients who will have a more aggressive disease course and predicting response to treatment and suggested a real-life diagnostic and therapeutic approach to CLL to update the current patient management in light of recent advances that have improved understanding of CLL. |
| first_indexed | 2024-12-16T14:58:33Z |
| format | Article |
| id | doaj.art-57cabc1a2ba642b9ba5fee1a21970cf6 |
| institution | Directory Open Access Journal |
| issn | 2240-256X |
| language | English |
| last_indexed | 2024-12-16T14:58:33Z |
| publishDate | 2020-02-01 |
| publisher | SEEd Medical Publishers |
| record_format | Article |
| series | Farmeconomia: Health Economics and Therapeutic Pathways |
| spelling | doaj.art-57cabc1a2ba642b9ba5fee1a21970cf62022-12-21T22:27:20ZengSEEd Medical PublishersFarmeconomia: Health Economics and Therapeutic Pathways2240-256X2020-02-0121110.7175/fe.v21i1.14521305Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany RegionMonica Bocchia0Alberto Bosi1Enrico Capochiani2Stefania Ciolli3Romano Danesi4Sara Galimberti5Alessandro Gozzetti6Sabrina Moretti7Ubaldo Occhini8Mario Petrini9AOU Senese, UOC Hematology, SienaAOU Careggi, Unità Funzionale di Ematologia, FirenzeAzienda Usl Toscana nord ovest, Ospedale di Livorno USL6, UO Dipartimentale di Ematologia, LivornoSODc di Ematologia – Azienda Ospedaliera Universitaria FirenzeAOU Pisana, UO Farmacologia Clinica e Farmacogenetica, PisaDepartment of Clinical and Experimental Medicine, UO Hematology, University of PisaHematology, University of Siena, Policlinico Le ScotteSoS Ematologia clinica e Oncoematologia, Firenze SOC Oncoematologia Dipartimento Oncologico, ASL toscana CentroAzienda Usl Toscana sud est, Ospedale San Donato – UO Ematologia, ArezzoAOU Pisana, UO Ematologia, PisaBACKGROUND: In the last years genomic and somatic alterations have shown to play a pivotal role in the pathogenesis of chronic lymphocytic leukemia (CLL) and new prognostic factors have been identified accordingly. AIM: To describe a real-life diagnostic and therapeutic approach to CLL that takes into account the role of genomic and somatic prognostic factors in the risk stratification of developing progressive disease, and treatment decision. METHODS: This new proposal has been developed and validated by ten key opinion leaders from Tuscany Region during two Expert Meetings. The approach suggested comes from their experience in daily clinical practice and is supported by guidelines recommendations, clinical trials results, and drugs prescribing conditions in Italy. RESULTS: Beside TP53 deletion or mutated status, the Expert Panel highlighted the importance of the IGHV mutation status characterization, since the diagnosis, in order to identify patients who will have a more aggressive progression. Furthermore, just before starting treatment, to obtain useful prognostic information and indication in the selection of the therapy, they recommend cytogenetic analysis for the detection of del(11q), trisomy 12, del(13q), del(17p), conventional karyotyping of stimulated CLL cells, TP53 sequencing, and molecular genetic analysis to detect IGHV mutation status. CONCLUSIONS: The Expert Panel recognized the limitations associated with traditional staging systems in identifying patients who will have a more aggressive disease course and predicting response to treatment and suggested a real-life diagnostic and therapeutic approach to CLL to update the current patient management in light of recent advances that have improved understanding of CLL.https://journals.seedmedicalpublishers.com/index.php/FE/article/view/1452chronic lymphocytic leukemiaprognostic factorstp53 deletionighv mutation status |
| spellingShingle | Monica Bocchia Alberto Bosi Enrico Capochiani Stefania Ciolli Romano Danesi Sara Galimberti Alessandro Gozzetti Sabrina Moretti Ubaldo Occhini Mario Petrini Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region Farmeconomia: Health Economics and Therapeutic Pathways chronic lymphocytic leukemia prognostic factors tp53 deletion ighv mutation status |
| title | Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region |
| title_full | Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region |
| title_fullStr | Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region |
| title_full_unstemmed | Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region |
| title_short | Real-life Diagnostic and Therapeutic Approach to CLL: A New Proposal from an Expert Panel in Tuscany Region |
| title_sort | real life diagnostic and therapeutic approach to cll a new proposal from an expert panel in tuscany region |
| topic | chronic lymphocytic leukemia prognostic factors tp53 deletion ighv mutation status |
| url | https://journals.seedmedicalpublishers.com/index.php/FE/article/view/1452 |
| work_keys_str_mv | AT monicabocchia reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT albertobosi reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT enricocapochiani reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT stefaniaciolli reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT romanodanesi reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT saragalimberti reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT alessandrogozzetti reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT sabrinamoretti reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT ubaldoocchini reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion AT mariopetrini reallifediagnosticandtherapeuticapproachtocllanewproposalfromanexpertpanelintuscanyregion |