The association between deaths from infection and mutations of the BRAF, FBXW7, NRAS and XPO1 genes: a report from the LRF CLL4 trial

Abstract Causes of death, in particular deaths due to infection, have not been widely studied randomised trials chronic lymphocytic leukaemia. With long-term follow-up (median 13 years) we examined the cause death 600/777 patients LRF CLL4 trial. Blood samples, taken at randomisation from 499 patients, were available for identifying gene mutations. Infection was a 258 (43%). Patients dying infection more likely than those who died other causes received ?2 lines treatment (194/258 [75%] versus 231/342 [68%], P = 0.04) and winter months (149/258 [58%] 166/342 [49%], 0.03), respectively. In with mutation data, factors significantly associated all 11q deletion (47/162 [29%] 40/209 [19%], 0.03) mutations BRAF, FBXW7, NRAS XPO1 genes. Death caused by an 46/67 assessable (69%) had one or these four genes only 129/333 (39%) without any (odds ratio: 3.46 [95% CI 1.98–6.07] < 0.0001). Careful management risk, including prophylaxis against may be important carry