Prognostic factors in chronic lymphocytic leukaemia – the old, the new and the future.

AbstractPrognostic assessment in chronic lymphocytic leukemia (CLL) is essential for delivery of timely, personalized therapy. <italic>TP53</italic> status, karyotype, IGHV mutational status, minimal residual disease (MRD), gene mutations and markers of cell proliferation were important prognostic tools in the era of chemo-immunotherapy (CIT). With BCL2 inhibitors (BCL2i), outcome is still impacted by IGHV status, <italic>TP53</italic> status, complex karyotype, and achievement of undetectable MRD. On the other hand, BTK inhibitors (BTKi) are agnostic to IGHV status, rarely cause MRD negative remissions and are less clearly impacted by <italic>TP53</italic> status. Although based on less mature data, outcomes with BCL2i/BTKi combinations are likely influenced by <italic>TP53</italic> and IGHV status. Responses to non-covalent BTKI (ncBTKI) are impacted by the mechanism of resistance to previous covalent BTKi. Finally, responses to chimeric antigen receptor T cell therapy (CAR-T) appear independent of <italic>TP53</italic> status, but dependent on overall T- cell fitness. [ABSTRACT FROM AUTHOR]