Clinical Significance of Cytogenetic Abnormalities Detected by FISH in CLL: Insights from a Real-World Single-Centre Cohort

<strong>Objective: </strong>Chronic lymphocytic leukemia (CLL) is a hematologic malignancy that predominantly affects the elderly. This study aimed to investigate cytogenetic alterations that could be used for risk assessment and treatment decisions in patients with CLL in relation to clinical parameters and outcomes. <strong>Materials and Methods: </strong>Peripheral blood samples from 101 CLL patients either newly diagnosed or previously diagnosed but untreated were analyzed using interphase fluorescence in situ hybridization (I-FISH) method with a CLL panel probe set. The associations among cytogenetic abnormalities, clinical features, treatment indications, and outcomes were statistically evaluated. <strong>Results: </strong>FISH analysis revealed statistically significant associations between specific cytogenetic abnor malities and clinical features. del(13q) and ATM deletion were significantly associated with large/sympto matic/progressive lymphadenopathy (LAP); ATM deletion was also linked to progressive splenomegaly. Regarding the causes of death, P53 deletion was significantly associated with secondary solid neoplasms and acute decompensated heart failure; trisomy 12 with disease progression and secondary solid neoplasms; and immunoglobulin heavy chain gene (IGH) rearrangement with tumor lysis syndrome. No significant difference in the overall survival was observed between the treated and untreated CLL patients. <strong>Conclusion: </strong>If validated in larger, multicenter cohorts, the novel associations identified between cytogenetic abnormalities and both treatment indications and causes of death could help guide the management of CLL.