IGH mutation

After receiving six cycles of brentuximab+doxorubicin, vinblastine, and dacarbazine (A+AVD) therapy at our Department of Hematology (University of Debrecen), the patient achieved complete metabolic remission (CMR) and remains in good condition. HL-RT in CLL is relatively rare and generally associated with poorer outcomes, though it is typically more favorable than DLBCL-RT. In this case report, we highlight not only an uncommon anatomical location of HL-RT but also the absence of typical predisposing factors, such as a TP53 mutation, unmutated immunoglobulin heavy chain (IGHV) status, or a lack of 13q deletion.

Biologically, CD38-negative cnMCLs appear to be more likely driven by CD38-independent, alternative signaling pathways. From a clinical perspective, identification of CD38-negative cnMCLs by flow cytometry may help recognizing patients at increased risk for adverse genetic features, including TP53 inactivation.

Br J Haematol 2026 (Online ahead of print). doi: 10.1111/bjh.70317.

This study provides the first comprehensive proteogenomic profile of MCL, offering novel insights into its molecular mechanisms and clinical behavior. The identification of molecular subtypes and prognostic protein signatures underscores the potential of proteomics to guide precision medicine strategies for MCL.

IGHV mutation analysis revealed that 25 out of 44 cases were mutated, with 13 of these cases having deletion 13q14 and 3 having trisomy 12. This study characterizes the genetic landscape of a cohort of Indian CLL patients through integrated cytogenetic and molecular analysis, highlighting recurrent aberrations and their distribution within the population.

Improving the rate of testing for specific high-risk molecular and genetic markers is vital to enhancing outcomes in patients with chronic lymphocytic leukaemia. In the era of proven efficacy of targeted agents, chemoimmunotherapy should be discouraged, in line with international guidelines.

This analysis provides insights into the clinical features and familial patterns of malignancy of individuals with POT1-TPD. Identification through genetic counseling and augmented cancer screening is paramount.

NGS revealed that a common progenitor cell with BCL2-IgH translocation and mutations in TP53, KMT2A, KMT2C, and KMT2D gave rise to two distinct subclones: one (CD5 + CD23+CD200+) CLL driven by mutations in TNFAIP3 and BCORL1, and the other (CD5-CD23-CD200-) driven by mutations in EP300, NOTCH1, and BCL2. This case highlights the significance of clonal heterogeneity in CLL and underscores the crucial role of MFC, flow sorting, and molecular genetics in diagnosing and understanding the complex evolution of this disease.

Successful fixed-duration regimens in CLL should achieve deep remission (i.e., undetectable minimal residual disease), sustain long-term progression-free survival, decrease the burden of treatment-related adverse events, and allow for re-treatment with minimal risk of drug resistance. Although fixed-duration treatment represents a positive step forward for most patients with CLL/SLL, the currently approved regimens often fall short in patients at high risk of progression. Continued research and development of next-generation drugs is essential to enhance efficacy and safety, ultimately improving outcomes in all patients with CLL/SLL.

Combining OGM and NGS analysis refined risk stratification beyond standard FISH panels and supports more precise, individualized management strategies in CLL. Prospective studies are warranted to evaluate the clinical utility of OGM-guided genomic profiling in contemporary treatment paradigms.

P2, N=80, Not yet recruiting, AstraZeneca | Trial completion date: Nov 2032 --> May 2029 | Initiation date: Sep 2025 --> Jan 2026 | Trial primary completion date: Nov 2032 --> May 2029

The primary first-line treatment options for CLL comprise continuous therapies based on the BTK inhibitors ibrutinib, zanubrutinib, or acalabrutinib, or fixed-duration regimens combining the BCL2 inhibitor venetoclax with obinutuzumab or the BTK inhibitors ibrutinib or acalabrutinib (with or without obinutuzumab). Selecting the appropriate targeted therapy requires careful evaluation of a multitude of factors, including molecular disease features (especially del[17p]/TP53 and IGHV mutational status), comorbidities, comedications, and the patient's preferences. Focusing on primary treatment options, we review data from the key controlled trials that support the first-line use of targeted therapies for patients with CLL, consider ongoing trials that may support clinical decision-making in the future, and assess the potential to personalize treatment regimens in CLL based on minimal residual disease status.