Presence of unbalanced chromosomal translocations independently predicts for treatment failure, short treatment-free (TFS) and overall survival (OS) in B-cell chronic lymphocytic leukemia (B-CLL) patients treated with cladribine.

Chromosomal translocations have recently emerged as an important prognostic indicator in B-CLL (Mayr et al, Blood 2006). Until now however, their value had neither been determined in patients undergoing homogeneous treatment, nor compared to that of IgVH mutational status, another major prognostic factor in B-CLL. Sixty-five B-CLL pts treated with cladribine-containing regimens were included in the present analysis. All had been investigated by conventional cytogenetic analysis using TPA as a mitogen, interphase FISH (tested loci: 11q/ATM, 12cen, 17p/P53, 13q/RB1&/D13S319), IgVH mutational status and P53 mutational screening prior to inclusion. Translocations (n= 45) were detected in 42 % of the pts, and included both balanced (n=12) and unbalanced (n=33) types. Pts with translocations were more heavily pretreated (P=.05) and presented with significantly higher incidence of complex aberrations (P