Else, Monica, Blakemore, Stuart J., Strefford, Jonathan C. and Catovsky, Daniel (2021). The association between deaths from infection and mutations of the BRAF, FBXW7, NRAS and XPO1 genes: a report from the LRF CLL4 trial. Leukemia, 35 (9). S. 2563 - 2570. LONDON: SPRINGERNATURE. ISSN 1476-5551

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Abstract

Causes of death, in particular deaths due to infection, have not been widely studied in randomised trials in chronic lymphocytic leukaemia. With long-term follow-up (median 13 years) we examined the cause of death in 600/777 patients in the LRF CLL4 trial. Blood samples, taken at randomisation from 499 patients, were available for identifying gene mutations. Infection was a cause of death in 258 patients (43%). Patients dying of infection were more likely than those who died of other causes to have received >= 2 lines of treatment (194/258 [75%] versus 231/342 [68%], P = 0.04) and to have died in the winter months (149/258 [58%] versus 166/342 [49%], P = 0.03), respectively. In patients with mutation data, the factors significantly associated with death from infection versus all other deaths were 11q deletion (47/162 [29%] versus 40/209 [19%], P = 0.03) and mutations of the BRAF, FBXW7, NRAS and XPO1 genes. Death was caused by an infection in 46/67 assessable patients (69%) who had a mutation of one or more of these four genes versus only 129/333 patients (39%) without any of these mutations (odds ratio: 3.46 [95% CI 1.98-6.07] P < 0.0001). Careful management of infection risk, including prophylaxis against infection, may be important in patients who carry these mutations.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Else, MonicaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blakemore, Stuart J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Strefford, Jonathan C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Catovsky, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-585393
DOI: 10.1038/s41375-021-01165-w
Journal or Publication Title: Leukemia
Volume: 35
Number: 9
Page Range: S. 2563 - 2570
Date: 2021
Publisher: SPRINGERNATURE
Place of Publication: LONDON
ISSN: 1476-5551
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
Oncology; HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/58539

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