{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T22:39:30Z","timestamp":1775860770107,"version":"3.50.1"},"reference-count":48,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T00:00:00Z","timestamp":1709856000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007076","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["IG-25024"],"award-info":[{"award-number":["IG-25024"]}],"id":[{"id":"10.13039\/501100007076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007076","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["IG-25024"],"award-info":[{"award-number":["IG-25024"]}],"id":[{"id":"10.13039\/501100007076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007076","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["P2022PSMX4"],"award-info":[{"award-number":["P2022PSMX4"]}],"id":[{"id":"10.13039\/501100007076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007076","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["IG-25024"],"award-info":[{"award-number":["IG-25024"]}],"id":[{"id":"10.13039\/501100007076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007076","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["IG-25024"],"award-info":[{"award-number":["IG-25024"]}],"id":[{"id":"10.13039\/501100007076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100007076","name":"Associazione Italiana per la Ricerca sul Cancro","doi-asserted-by":"publisher","award":["P2022PSMX4"],"award-info":[{"award-number":["P2022PSMX4"]}],"id":[{"id":"10.13039\/501100007076","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Chronic lymphocytic leukemia (CLL) exhibits substantial variability in disease course. The mutational status of the B-cell receptor immunoglobulin heavy variable (IGHV) chain is a critical prognostic factor, categorizing patients into mutated (M-IGHV) and unmutated (U-IGHV) groups. Recently, a third subgroup with borderline mutational status (BL-IGHV) has been identified, comprising approximately 5% of CLL cases. This study retrospectively analyzes the outcomes of 30 BL-IGHV mutated patients among a cohort of 653 CLL patients, focusing on time to first treatment (TTFT) and overall survival (OS). BL-IGHV patients had a short TTFT similar to U-IGHV patients (median 30.2 vs. 34 months; p = 0.9). Conversely, the OS of BL-IGHV patients resembled M-IGHV patients (median NR vs. 258 months; p = 1). Despite a similar incidence in unfavorable prognostic factors, the TTFT was shorter compared to other published cohorts. However, striking similarities with other experiences suggest that BL-IGHV mutated patients share common biological characteristics, biased IGHV gene usage and BCR subset frequency. These findings also underscore the need for multicentric efforts aggregating data on BL-IGHV CLL in order to elucidate its disease course and optimize therapeutic approaches for this rare subgroup. Until then, predicting outcomes and optimal management of BL-IGHV CLL will remain challenging.<\/jats:p>","DOI":"10.3390\/cancers16061095","type":"journal-article","created":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T05:44:06Z","timestamp":1709876646000},"page":"1095","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Chronic Lymphocytic Leukemia (CLL) with Borderline Immunoglobulin Heavy Chain Mutational Status, a Rare Subgroup of CLL with Variable Disease Course"],"prefix":"10.3390","volume":"16","author":[{"given":"Francesco","family":"Angotzi","sequence":"first","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Cellini","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeria","family":"Ruocco","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara Adele","family":"Cavarretta","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Zatta","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Serafin","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Pravato","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9535-0526","authenticated-orcid":false,"given":"Elisa","family":"Pagnin","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Bonaldi","sequence":"additional","affiliation":[{"name":"Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Frezzato","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0100-5789","authenticated-orcid":false,"given":"Monica","family":"Facco","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2831-623X","authenticated-orcid":false,"given":"Francesco","family":"Piazza","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1222-6149","authenticated-orcid":false,"given":"Livio","family":"Trentin","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0271-7200","authenticated-orcid":false,"given":"Andrea","family":"Visentin","sequence":"additional","affiliation":[{"name":"Hematology Unit, Department of Medicine, University of Padova, 35128 Padua, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1001\/jama.2023.1946","article-title":"Diagnosis and Treatment of Chronic Lymphocytic Leukemia: A Review","volume":"329","author":"Shadman","year":"2023","journal-title":"JAMA"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2745","DOI":"10.1182\/blood-2017-09-806398","article-title":"iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of 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