Hématologie biologique, hôpital Avicenne, Bobigny, France
In the era of targeted therapies, the management of chronic lymphocytic leukaemia (CLL) has evolved. A pre-therapeutic genetic assessment is now indispensable to guide the choice of therapeutic strategy adapted to each patient. On the one hand, CLL is clinically heterogeneous, with one third of patients never being treated. On the other hand, relapses are frequent, and patients often receive several lines of therapy. There are two types of genetic markers, those that are predictive of the response to treatment and guide the therapy and those that are prognostic and help to stratify and improve patient follow-up. The decision to initiate treatment remains based on the clinical stage. Genetic analysis, based on the mutational status of TP53 and IGHV, can help to choose between immunochemotherapy and targeted therapy.