Table 2.

Guideline recommendations for TP53 and IGHV analysis in clinical practice.

Society	Recommendation	Timing
iwCLL
TP53 disruption	Always	Prior to treatment
IGHV gene mutational status	Always	Prior to treatment
BCSH
TP53 disruption	Always	Prior to treatment
IGHV gene mutational status	“Should be considered”	Prior to treatment
NCCN
TP53 disruption	Always	At diagnosis or prior to treatment 1
IGHV gene mutational status	Always	At diagnosis or prior to treatment
ESMO
TP53 disruption	Always	Prior to treatment
IGHV gene mutational status	“Desirable”	Prior to treatment

TP53 disruption includes both del17p by fluorescent in-situ hybridization and TP53 gene mutational analysis by either Sanger or next-generation sequencing. ¹ In the case of analysis performed in early-stage disease under a “watch-and-wait” strategy or relapsed/refractory cases undergoing subsequent therapy, TP53 analysis should be repeated prior to treatment to assess effects of clonal evolution. Abbreviations: IGHV, immunoglobulin heavy chain variable gene; iwCLL, international workshop on chronic lymphocytic leukemia; BCSH, British committee for standards in haematology; NCCN, national comprehensive cancer network; ESMO, European society for medical oncology.