Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma (CLLSLL)
Overview
CLL/SLL is a Mature B-Cell Neoplasm (parent MBN). IGHV-mutated (M-CLL) and IGHV-unmutated (U-CLL) define major molecular subtypes with distinct driver landscapes and prognoses.
Cohorts in the corpus
- cll_broad_2022: 1,148 patients (1,095 CLL, 54 MBL); WES/WGS n=1,074 (984 WES, 177 WGS); RNA-seq n=712; DNA methylation n=999 — the largest integrated CLL cohort to date PMID:35927489.
Recurrent alterations
- Cardinal drivers: SF3B1 17.5%, NOTCH1 12.3%, ATM 11.2%, TP53 9.1% PMID:35927489.
- 202 candidate drivers (109 novel); 24.2% of patients carry at least one novel driver mutation PMID:35927489.
- Non-coding/non-standard drivers: IGLV3-21 R110 9.5%, U1 snRNA g.3A>C 3.8% PMID:35927489.
- Novel drivers via 3D CLUMPS clustering include MAP2K2, DIS3, DICER1, INO80 PMID:35927489.
- Recurrent SVs: BCL2 translocations predominantly in M-CLL (5.7% of WGS cases) via aberrant V(D)J; recurrent 37-Mb chr14 deletion disrupting ZFP36L1, DICER1, TRAF3 in U-CLL (4.6%) via class-switch recombination PMID:35927489.
- Mutational signatures: canonical AID (SBS84) enriched in U-CLL; non-canonical AID (SBS85) enriched in M-CLL (p=1.6×10^-9) PMID:35927489.
- WES of 160 CLL tumors identified SF3B1, NOTCH1, DDX3X, and POT1 as significantly mutated genes; SF3B1 mutations associated with poor prognosis PMID:23415222
- Genomic profiling of CLL/SLL identified recurrent alterations in SF3B1, NOTCH1, ATM, and TP53; mutational landscape informs prognosis and therapeutic targeting PMID:26200345
- Genomic analysis of CLL/SLL identified recurrent driver mutations and copy number alterations informing disease prognosis and targeted therapy strategies PMID:26466571
Subtypes
- IGHV-unmutated CLL (U-CLL, n=459) harbors more drivers than IGHV-mutated CLL (M-CLL, n=512): 54 vs 25 drivers (ratio 2.16, p=0.0015) PMID:35927489.
- 8 gene-expression clusters identified by unsupervised RNA-seq clustering (n=603 treatment-naive) are independent prognostic factors beyond IGHV/epitype PMID:35927489.
- Epitype framework (n-CLL, i-CLL, m-CLL) with epiCMIT mitotic clock PMID:35927489.
Therapeutic landscape
- In the era of ibrutinib/venetoclax, isolated TP53 mutation (without 17p deletion) does not confer adverse prognosis in U-CLL PMID:35927489.
- RRM1 is a U-CLL-specific novel driver and a target of fludarabine PMID:35927489.
Sources
This page was processed by crosslinker on 2026-05-14. - PMID:23415222
This page was processed by crosslinker on 2026-05-14. - PMID:26200345
This page was processed by crosslinker on 2026-05-14. - PMID:26466571
This page was processed by crosslinker on 2026-05-14.