TP53 dysfunction in chronic lymphocytic leukemia: clinical relevance in the era of B-cell receptors and BCL-2 inhibitors.

INTRODUCTION

Patients with dysfunction, assessed by del(17p) or mutations, respond poorly to chemo-immunotherapy and fare better with the new therapies (BCR and BCL-2 inhibitors); however, it is unclear whether their response is similar to that of patients without anomalies or whether there is currently an adequate determination of dysfunction.

AREA COVERED

A literature search was undertaken on clinical trials and real-world experience data on patients with dysfunction treated with different protocols. Moreover, data on the biological function and on the tests currently employed for its assessment were reviewed.

EXPERT OPINION

Although dysfunction has less negative influence on the new biological therapies, patients with these alterations, particularly those with biallelic inactivation of , have a worst outcome with these therapies than those without alterations. At present, a determination of , particularly with next generation sequencing (NGS) methodologies, may be sufficient for the identifications of the patients unsuitable for chemo-immunotherapy, although integration with del(17p) would be advisable. For the future, more extensive determinations of the status, including functional assays, may become part of the current armamentarium for a better patient stratification and treatment with newer protocols.