Fc receptor-like 2 (FCRL2) is a novel marker of low-risk CLL and refines prognostication based on IGHV mutation status

Abstract

Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in Western countries and is characterized by a progressive accumulation of CD5 + monoclonal B cells in the blood and bone marrow. The clinical course in CLL is remarkably heterogeneous; the monoclonal population may expand in a protracted fashion over many years or increase rapidly, leading to bulky infiltration of lymphoid organs, progressive cellular and humoral immunodeficiency, autoimmunity, and cytopenias 1,2 . Prognostication at the time of diagnosis has important implications for patient care and has been an active area of investigation over the past several decades. Various means of risk stratification have been developed and validated, including clinical stage Composite prognostic indices, such as the German CLL Study Group prognostic score and the CLL-IPI, have also been proposed Despite an abundance of validated prognostic indicators, decisions to initiate treatment are still based on the presence of symptoms and/or cytopenias, and there is no evidence yet that preemptive treatment based on adverse prognostic factors improves overall survival (OS). Therefore, the search for reliable and widely available indicators that can be easily assayed at diagnosis and integrated to refine prognostication in CLL is ongoing.