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Risk Stratification in Chronic Lymphocytic Leukemia

The Role of the Clinical Laboratory



Immunoglobulin Variable (IgVH) Region Mutation Status

Slide 26

November 2008

Immunoglobulin variable region (IgVH) mutation status has been established as an important marker for prognosis in patients with CLL. This is a very complicated technique that requires PCR amplification of the IgVH region, followed by DNA sequencing. A mutation percentage is determined by dividing the number of mutations identified by the total base pairs analyzed. If the number of mutations is less than 2%, it is then considered as unmutated, which is a poor prognostic finding. If it is greater than 2%, it is considered as mutated which is associated with a good prognosis.

IgVH mutation status has been a very good marker when used in population studies. In our experience, it may not necessarily have the best reproducibility across laboratories, and without a doubt, it is a very sophisticated technique which is not easily adaptable to the clinical laboratory.

IgVH Region Mutation Status

 


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