Clinical, radiological and pathological features of RT in patients receiving venetoclax at progression
| Case no. . | F-refractory . | Prognostic factors at entry . | . | . | . | Nodal PD . | . | PET features . | BM at time of RT . | IHC of RT . | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Complex . | Del17p . | TP53 mutated . | Best response to Ven . | TTP (mo) . | B symptoms . | Clin . | CT . | Other features . | No. avid nodes . | SUVmax . | % Large cells . | % CLL . | p53 . | BCL2 . | MYC . | Ki67 . | EBV . | ||
| RT–DLBCL | |||||||||||||||||||
| 1 | − | ND | + | + | PR | 4.1 | − | + | + | Rapid multifocal PD | ND | ND | ND | ND | + | + | ND | 95% | − |
| 2 | + | + | + | + | PR | 4.4 | + | − | − | Cytopenias; BM involved | 6 | 22 | + | Heavy | + | + | + | 80% | ND |
| 3 | − | ND | − | − | PR | 5.3 | − | + | + | Localized nodal PD | ND | ND | − | <5% | + | + | + | 95% | + |
| 4 | + | + | − | + | SD | 5.6 | − | − | + | Cytopenias; mixed nodal response | 3 | 11 | − | 20% | + | + | ND | 60% | ND |
| 5 | + | + | + | + | PR | 7.1 | − | + | + | Multiple-nodal PD | ND | ND | − | 1% | ND | + | + | 60-70% | ND |
| 6 | − | − | − | − | SD | 7.9 | + | − | − | Abnormal LFTs | 6 | 14 | − | 10-15% | + | + | − | ND | ND |
| 7 | + | ND | − | − | PR | 8.5 | − | − | + | Pleural; PET-avid BM | EN | ND | − | 20% | + | + | ND | 30% | ND |
| 8 | + | − | + | + | PR | 10.6 | − | − | + | Mixed nodal response | 11 | 25.2 | − | 5-10% | + | + | ND | ND | ND |
| 9 | + | + | + | − | PR | 15.7 | − | − | + | Single-node PD | 1 | * | − | 5-10% | ND | ND | 25% | − | |
| 10 | + | − | + | − | PR | 15.8 | − | + | ND | Tonsillar mass | 6 | 44 | − | 5% | ND | + | + | 90% | − |
| 11 | − | ND | + | − | PR | 16.9 | − | − | + | 6 | 10 | − | <5% | + | + | + | 33% | ND | |
| 12 | − | ND | − | + | PR | 17.4 | − | − | + | Cytopenias | 12 | 23 | + | 0 | − | + | ND | ND | ND |
| 13 | + | ND | + | − | PR | 22.3 | + | − | + | Cytopenias | ND | ND | + | MRD+ | − | + | ND | ND | ND |
| 14 | − | + | − | − | CR | 23 | + | − | + | Multiple-nodal PD | ND | ND | − | 30% | + | + | − | 25% | − |
| RT-HL | |||||||||||||||||||
| 15 | + | + | − | ND | SD | 1 | + | − | − | 9 | 15 | ND | ND | ND | − | ND | ND | + | |
| 16 | − | ND | − | − | SD | 5.7 | + | + | + | 3 | 16 | − | <5% | ND | − | ND | ND | + | |
| 17 | + | ND | − | ND | PR | 5.8 | − | + | + | Single-node PD | 1 | 9.2 | ND | ND | ND | − | ND | ND | + |
| Case no. . | F-refractory . | Prognostic factors at entry . | . | . | . | Nodal PD . | . | PET features . | BM at time of RT . | IHC of RT . | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Complex . | Del17p . | TP53 mutated . | Best response to Ven . | TTP (mo) . | B symptoms . | Clin . | CT . | Other features . | No. avid nodes . | SUVmax . | % Large cells . | % CLL . | p53 . | BCL2 . | MYC . | Ki67 . | EBV . | ||
| RT–DLBCL | |||||||||||||||||||
| 1 | − | ND | + | + | PR | 4.1 | − | + | + | Rapid multifocal PD | ND | ND | ND | ND | + | + | ND | 95% | − |
| 2 | + | + | + | + | PR | 4.4 | + | − | − | Cytopenias; BM involved | 6 | 22 | + | Heavy | + | + | + | 80% | ND |
| 3 | − | ND | − | − | PR | 5.3 | − | + | + | Localized nodal PD | ND | ND | − | <5% | + | + | + | 95% | + |
| 4 | + | + | − | + | SD | 5.6 | − | − | + | Cytopenias; mixed nodal response | 3 | 11 | − | 20% | + | + | ND | 60% | ND |
| 5 | + | + | + | + | PR | 7.1 | − | + | + | Multiple-nodal PD | ND | ND | − | 1% | ND | + | + | 60-70% | ND |
| 6 | − | − | − | − | SD | 7.9 | + | − | − | Abnormal LFTs | 6 | 14 | − | 10-15% | + | + | − | ND | ND |
| 7 | + | ND | − | − | PR | 8.5 | − | − | + | Pleural; PET-avid BM | EN | ND | − | 20% | + | + | ND | 30% | ND |
| 8 | + | − | + | + | PR | 10.6 | − | − | + | Mixed nodal response | 11 | 25.2 | − | 5-10% | + | + | ND | ND | ND |
| 9 | + | + | + | − | PR | 15.7 | − | − | + | Single-node PD | 1 | * | − | 5-10% | ND | ND | 25% | − | |
| 10 | + | − | + | − | PR | 15.8 | − | + | ND | Tonsillar mass | 6 | 44 | − | 5% | ND | + | + | 90% | − |
| 11 | − | ND | + | − | PR | 16.9 | − | − | + | 6 | 10 | − | <5% | + | + | + | 33% | ND | |
| 12 | − | ND | − | + | PR | 17.4 | − | − | + | Cytopenias | 12 | 23 | + | 0 | − | + | ND | ND | ND |
| 13 | + | ND | + | − | PR | 22.3 | + | − | + | Cytopenias | ND | ND | + | MRD+ | − | + | ND | ND | ND |
| 14 | − | + | − | − | CR | 23 | + | − | + | Multiple-nodal PD | ND | ND | − | 30% | + | + | − | 25% | − |
| RT-HL | |||||||||||||||||||
| 15 | + | + | − | ND | SD | 1 | + | − | − | 9 | 15 | ND | ND | ND | − | ND | ND | + | |
| 16 | − | ND | − | − | SD | 5.7 | + | + | + | 3 | 16 | − | <5% | ND | − | ND | ND | + | |
| 17 | + | ND | − | ND | PR | 5.8 | − | + | + | Single-node PD | 1 | 9.2 | ND | ND | ND | − | ND | ND | + |
The table summarizes the key clinical features, the PET findings, and the degree of bone marrow (BM) infiltration by CLL at the time of diagnosis of RT. Immunohistochemical analyses of the RT biopsy for each patient are also summarized.
EBV, Epstein-Barr virus; EN, extranodal disease only; MRD+, no morphological CLL infiltrate detected, positive for CLL only by 4-color flow cytometry; LFT, liver function test; NA, not applicable; ND, not done; SD, stable disease; Ven, venetoclax; +, present (see “Methods” for details); −, absent.
PET performed after core biopsy of only avid node, so SUVmax reading uncertain.