Immunoglobulin heavy variable somatic hyper mutation status in chronic lymphocytic leukaemia: on the threshold of a new era?

摘要

Since the introduction of the gene somatic hypermutation (SHM) status as prognostic marker in chronic lymphocytic leukaemia (CLL) patients in the two 1999 landmark publications from the Stevenson and Chiorazzi groups (Damle , ; Hamblin , ), its value has been consistently confirmed in virtually all CLL cohorts analysed thus far. To distinguish good from poor prognostic CLL subgroups, a threshold of 98% identity to the closest germline (=unrearranged) immunoglobulin heavy variable ( ) gene was introduced. CLL cases showing a clonally rearranged gene with <98% identity to the closest gene (classified as IG‐mutated CLL, M‐CLL) constitute the more favourable group, while those with ≥98% identity (unmutated CLL, U‐CLL) represent the adverse group.