Complex Karyotype

My CLL is characterized by IGVH unmutated, deletion 11q, deletion 13q, and CD38 positive. There is no question that I fall into the high risk CLL bucket. But am I also a complex karyotype? My understanding is that the definition of complex karyotype is 3 or more CLL cell mutations. I know I have 2 (deletions of 11q and 13 q), but I'm not certain if CD38 positive is also considered a cell mutation. My reason for caring is that I have read that a complex karyotype increases the likelihood of ibrutinib resistance. I'm currently in remission, but am always interested in what future treatments my be effective for me

Help from the experts on this is appreciated.

5 Replies

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  • CD38 (Clusters of Differentiation type 38) is a prognostic indicator, not a genetic mutation of the CLL cell's DNA, though obviously something in the cells' make-up causes the variance in the degree of expression. CD38 positive means that your CLL cells express more than specific threshold of (CD38) on their cell membranes and you can have a variation in the amount of CD38 expression between different CD38+ CLL cells. The chosen CD38 positive/negative threshold varies, but is typically 20 or 30%. Importantly, this positive/negative characterisation doesn't tell you what type of distribution your CLL cells have, or how this may change over time. Check out figure 2 of this reference: onlinelibrary.wiley.com/doi...

    How long your remission lasts will obviously be influenced by how your various CLL clones change over time and which one(s) emerge as dominant.

    Neil

  • Neil,

    Thanks. Chris also responded on another forum where I posted this. Bottom line is more tests would need to be run to determine if I have a complex karyotype. No reason to worry about it at the present time.

    Ken

  • I am no expert, but I am also IGVH unmutated as well as 17p deletion. It may be worth noting that the number one thing Dr. Byrd at OSU was concerned about when choosing a treatment plan was that I have complex karyotypes, not 17p deletion, because of the relapse risk with ibrutinib. This was a surprise to me, and something I hadn't read online previously. It is certainly a treatment option that would work for awhile, but the good news is there are a lot more meds coming on line, and by the time you relapse, there will likely be a better option for you than ibrutinib. Hope your remission lasts many years.

  • That was the reason for my question.

  • Very well said. 🙏🏻

    Jeff

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