Přehled o publikaci

In the era of chemoimmunotherapy, high-risk chronic lymphocytic leukaemia (CLL) was defined by the presence of TP53 loss and/or TP53 mutation and by refractoriness to purine‐analogue based treatment (no remission or remission under 6 months in duration), respectively. The advent of chemo‐free treatment regimens at all disease stages requires a re‐definition of the term “high‐risk CLL”, but this constitutes a challenging task when considering the rapidly evolving treatment landscape and the increasing knowledge about CLL pathobiology obtained over recent years. While CLL characterization used to focus on clinical parameters and limited genomic analyses, samples can nowadays be analysed in a far more comprehensive manner, since “omics” technologies allow an integrative analysis of data obtained at the genomic, epigenomic, transcriptomic, and proteomic level as well as an assessment of spatial tumor heterogeneity and tumor evolution over time. Next to intrinsic CLL characteristics, a growing understanding about the interplay of CLL cells with their microenvironment provides additional aspects to consider for CLL risk stratification. The wealth of information that can in principle be obtained for each CLL case challenges the identification of biomarkers conferring poor prognosis and predicting treatment failure.