ATM mutation rather than BIRC3 deletion and/or mutation predicts reduced survival in 11q-deleted chronic lymphocytic leukemia: data from the UK LRF CLL4 trial

Research output: Contribution to journalArticle


  • Matthew J J Rose-Zerilli
  • Jade Forster
  • Helen Parker
  • Anton Parker
  • Ana E Rodríguez
  • Tracy Chaplin
  • Anne Gardiner
  • Andrew J Steele
  • Andrew Collins
  • Bryan D Young
  • Anna Skowronska
  • Daniel Catovsky
  • David G Oscier
  • Jonathan C Strefford

Colleges, School and Institutes


ATM mutation and BIRC3 deletion and/or mutation have independently been shown to have prognostic significance in chronic lymphocytic leukemia. However, the relative clinical importance of these abnormalities in patients with a deletion of 11q encompassing the ATM gene has not been established. We screened a cohort of 166 patients enriched for 11q-deletions for ATM mutations and BIRC3 deletion and mutation and determined the overall and progression-free survival among the 133 of these cases treated within the UK LRF CLL4 trial. SNP6.0 profiling demonstrated that BIRC3 deletion occurred in 83% of 11q-deleted cases and always co-existed with ATM deletion. For the first time we have demonstrated that 40% of BIRC3-deleted cases have concomitant deletion and mutation of ATM. While BIRC3 mutations were rare, they exclusively occurred with BIRC3 deletion and a wild-type residual ATM allele. In 11q-deleted cases, we confirmed that ATM mutation was associated with a reduced overall and progression-free survival comparable to that seen with TP53 abnormalities, whereas BIRC3 deletion and/or mutation had no impact on overall and progression-free survival. In conclusion, in 11q-deleted patients treated with first-line chemotherapy, ATM mutation rather than BIRC3 deletion and/or mutation identifies a subgroup with a poorer outcome.


Original languageEnglish
Pages (from-to)736-42
Number of pages7
Issue number4
Publication statusPublished - Apr 2014


  • Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Ataxia Telangiectasia Mutated Proteins, Chromosome Aberrations, Chromosomes, Human, Pair 11, Female, Gene Deletion, Humans, Inhibitor of Apoptosis Proteins, Leukemia, Lymphocytic, Chronic, B-Cell, Male, Middle Aged, Mutation, Neoplasm Staging, Patient Outcome Assessment, Polymorphism, Single Nucleotide, Prognosis, Sequence Deletion