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IGHV mutational status

Whether the leukaemia's antibody gene has been 'edited' by the immune system. Unmutated means faster-growing CLL and a bigger benefit from targeted drugs over chemotherapy.

IGHV genes with <2% deviation from germline are 'unmutated' (~40-50% of CLL) and predict shorter time to treatment and poor response to chemoimmunotherapy (FCR). BTK inhibitors and venetoclax combinations largely erase the difference for progression, and IGHV status is a stratification factor in every modern CLL trial (CLL13, AMPLIFY). Mutated-IGHV patients still achieve the longest remissions after fixed-duration therapy.

Biomarkers: what this kind of term is about · animated schematic, not to scale
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Biomarkers

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