SCIENTIFIC PROGRAMME
SESSION I
THE GENOMIC AND
EPIGENOMIC LANDSCAPE
OF CLL AND CLINICAL
CONSEQUENCES
SESSION II
THE ROLE OF BCR
ACTIVATION AND
SIGNALLING FOR CLL
SESSION III
THERAPEUTIC OPTIONS
FOR CLL
SESSION IV
LONG TERM FOLLOW
UP OF CLINICAL TRIALS
VERSUS REAL WORLD
DATA (OUTSIDE CLINICAL
TRIALS DATA-OCT)
SESSION V
THE INCREASING ROLE
OF THE LEUKAEMIC
MICROENVIRONMENT
SESSION VI
THERAPEUTIC OPTIONS 2 :
THE USE OF CELLULAR
AND NON-CELLULAR
IMMUNOTHERAPIES IN
CLL
SESSION VII
EFFICACY THROUGH
SAFETY
SESSION VIII
CLONAL HETEROGENEITY,
CLONAL EVOLUTION AND
MECHANISMS OF DRUG
RESISTANCE
SESSION IX
CONTRASTING
THERAPEUTIC CONCEPTS
SELECTED ABSTRACTS
FOR AN ORAL
PRESENTATION
SELECTED ABSTRACTS
FOR A POSTER
PRESENTATION
FACULTY DISCLOSURES
GOOD RESPONSE TO FC-R IN PATIENT WITH LOW LEVEL DEL(17)P CLL CLONE
Cláudia Pedrosa, Rita Coutinho and Jorge Coutinho
Department of Clinical Hematology, Centro Hospitalar Universitário do Porto, Porto, Portugal
Introduction : The deletion of the short arm of chromosome 17 is presently known to be one
of the major prognosis factors in CLL. Patients having del(17)p are at higher risk of treatment
failure with chemoimmunotherapy and disease progression, being characteristically a group
with poor overall survival. The advent of novel agents, like B-cell receptor inhibitors, seemed
to improve the outcome of this population comparing to the standard treatment. The
percentage of cells with the chromosomic mutation has an important role in the treatment
decision.
Clinical Case : A 56-year-old woman was referenced to the hematologist for generalized
lymphadenopathy, weight loss (2kg) and lymphocytosis (36657/μL). Gumprecht shadows and
atypical lymphocytes (15%) were present on the peripheral blood smear. Imunophenotyping
of peripheral blood was conclusive of CLL, with ZAP-70 positivity in 79% of the cells. Del(17)p
was detected on 15% of 200 monoclonal B cells.
CT scan showed enlargement of Waldeyer ring, low size lymph nodes on the neck, axillae and
retroperitoneal area, splenomegaly (16 cm), as well as isolated right lung and right kidney
nodules.
The patient was diagnosed with CLL stage IIB Rai-Binet. Given the size of the del(17)p+ clone,
she received chemoinumotherapy with FC-R (Fludarabine, Cyclophosphamide and Rituximab)
for 6 cycles achieving a complete response on the CT scan and negative minimal residual
disease on peripheral blood.
Presently, the patient is still in complete remission 9 months after completing FC-R.
Conclusion : The authors report a case of a patient with low percentage del(17)p monoclonal
B cells, in which FC-R proved to be an effective treatment. Patients with del(17)p CLL have an
heterogeneous outcome. In spite of del(17)p being an important prognosis factor, there are
other clinical, biological, phenotypic, cytogenetic and molecular markers that can have great
impact on the outcome of these patients.
POSTER 34