Subject 11q VH Mutated or VH UnMutated?

[Guest guest]

Hi List Members,

I am looking for some help interpreting the results of my

recent tests. In particular I am hoping Dr. Hamblin may be

able to respond.

I was offered the opportunity to have Multiplex Litigation-

dependent Probe Amplification (MLPA) done on my blood at no

cost to me instead of having a FISH which I would have had

to pay for. The report concludes that " evidence of a

chromosome 11q23 deletion was detected " in a peripheral

blood sample. I also had IvGH done at a different lab. The

results reported " Mutation Rate: 3.04% " based on " sequence

analysis the clonal IgVH gene belongs to the VH1-69 family. "

I have read up on the 11q deletion and feel I have a

reasonable understanding of its possible unfavorable

implications for CLL patients. I have also read up on IgVH

mutation status and its association with more indolent

versus more aggressive CLL. I am hoping someone can help me

interpret my IvGH mutation status report because it is

unexpected given the 11q-23 deletion.

I read in several places including Dr. Hamblin's blogs that

11q deletion is almost always associated with umutated IgVH.

In his June 2010 blog while discussing IvGH as a prognostic

indicator Dr. Hamblin wrote, " This isn't a foolproof test.

Being unmutated does not guarantee early treatment and being

mutated doesn't guarantee late treatment or no treatment. I

have written before that there are some borderline cases

with 97% homology who tend to include some cases that are

effectively unmutated and of course, those who use the V3-21

gene behave as if they were unmutated even when they are

mutated. "

http://mutated-unmuated.blogspot.com/2010/06/where-are-we-with-prognostic-marker\

s.html

or http://tinyurl.com/68nx8ug

Because my mutation rate is 3.04% as reported by my IvGH

test and the 11q-23 deletion found in my blood is usually

associated with unmutated VH status, could I be one of the

borderline cases Dr. Hamblin is referring to? That I might

actually be unmutated despite the mutated determination of

the lab report? If not, what sort of prognosis is associated

with 11q coexisting with mutated VH status? I ask this

because, to borrow from Dr. Hamblin, just like I watch the

weather forecasts, I want to know something about the

possible future so I can plan for it. I will also add that

my CD38 was 20% two years ago at diagnosis.

P.