High karyotypic complexity is an independent prognostic factor in patients with CLL treated with venetoclax combinations

Karotyping could prove useful as part of the standard CLL work-up for identifying patients at high risk for poor treatment outcomes. Researchers prospectively evaluated patients in the GAIA (CLL13) trial who had complex (≥ 3 chromosomal aberrations, n = 115) and highly complex karyotypes (≥ 5 chromosomal aberrations, n = 43). All patients were received either chemoimmunotherapy or time-limited venetoclax-based therapies. For those patients who received chemoimmunotherapy, complex karyotype (> 3 chromosomal aberrations) were associated with shorter PFS (HR 2.58; 95% CI: 1.54 - 4.32; p < 0.001) and OS (HR 3.25; 95% CI: 1.03- 10.26; p = 0.044). However, only highly complex karyotypes (> 5 chromosomal aberrations) were determined to be adverse predictors for PFS (HR 1.96; 95% CI: 1.03 - 3.72, p = 0.041) for those patients who received venetoclax. Additionally, although chemoimmunotherapy was associated with the acquisition of additional chromosomal abberations post-treatment, this was not seen with venetoclax-based regimens.