Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia with high heterogeneity in the western world. Thus, investigators identified a number of prognostic biomarkers and scoring systems to guide treatment decisions and validated them in the context of immunochemotherapy. A better understanding of prognostic biomarkers, including serum markers, flow cytometry outcomes, IGHV mutation status, microRNAs, chromosome aberrations and gene mutations, have contributed to prognosis in CLL. Del17p/ TP53 mutation, NOTCH1 mutation, CD49d, IGHV mutation status, complex karyotypes and microRNAs were reported to be of predictive values to guide clinical decisions. Based on the biomarkers above, classic prognostic models, such as the Rai and Binet staging systems, MDACC nomogram, GCLLSG model and CLL-IPI, were developed to improve risk stratification and tailor treatment intensity. Considering the presence of novel agents, many investigators validated the conventional prognostic biomarkers in the setting of novel agents and only TP53 mutation status/del 17p and CD49d expression were reported to be of prognostic value. Whether other prognostic indicators and models can be used in the context of novel agents, further studies are required.

中文翻译：

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慢性淋巴细胞白血病的预后生物标志物和风险评分系统的最新进展。

慢性淋巴细胞性白血病（CLL）是西方世界中最常见的高度异质性成人白血病。因此，研究人员确定了许多预后生物标志物和评分系统以指导治疗决策，并在免疫化学疗法的背景下对其进行了验证。对预后生物标志物的更好理解，包括血清标志物，流式细胞术结果，IGHV突变状态，microRNA，染色体畸变和基因突变，有助于CLL的预后。据报道，Del17p / TP53突变，NOTCH1突变，CD49d，IGHV突变状态，复杂的核型和microRNA具有指导临床决策的预测价值。根据上述生物标记物，可以使用经典的预后模型，例如Rai和Binet分期系统，MDACC nomogram，GCLLSG模型和CLL-IPI，旨在改善风险分层并调整治疗强度。考虑到新药的存在，许多研究者在新药设置中验证了常规的预后生物标志物，据报道只有TP53突变状态/ del 17p和CD49d表达具有预后价值。是否可以在新型药物的背景下使用其他预后指标和模型，还需要进一步的研究。