Fish Cytogenetics In

It has previously been shown that conventional cyto-genetics, using banding techniques, provide inconsistently reliable results in CLL because leukemic lymphocytes in this disease do not readily yield readable metaphases.8 The development of fluorescence in situ hybridization (FISH) techniques and the availability of DNA probes for all chromosomes of interest in CLL have made it possible to study chromosomal abnormalities in this disease. Using FISH, we now can divide CLL patients into distinct prognostic categories based on chromosomal abnormalities.8 Patients with 13q deletions as a single abnormality have the best survival. High-risk abnormalities and the shortest survival were observed with 11q del and 17p del, while trisomy 12 (12+) and no chromosomal abnormality patients form the intermediate survival group.8 As FISH methodology has become standardized, we believe that low-risk or intermediate-risk (by clinical staging) group patients who are free of symptoms but have 17p del or 11q del could be considered for early intervention, especially when they participate in a prospectively randomized study with one arm consisting of wait and watch (currently the standard of practice for patients in these clinical stages), and the other arm consisting of some regimen of effective chemotherapy.

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