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Access through your institution Buy or subscribe Ultra-deep next-generation DNA sequencing of genes commonly mutated in patients with chronic lymphocytic leukaemia (CLL) has been used to

investigate the clonal and subclonal dynamics of the disease. Subclonal mutations were found to be common, with or without clonal mutations. Importantly, clonal _SF3B1_ mutations, and clonal

or subclonal mutations in _ATM_ and _NOTCH1_ predicted shorter time to first treatment, independent of _IGHV_ mutational status. Moreover, clonal and subclonal mutations in _TP53_, and

clonal mutations in _NOTCH1_ were associated with shorter overall survival. Clonal evolution occurred over time, particularly after treatment, but was also observed in untreated patients.

These results suggest that longitudinal evaluation of the clonal architecture of CLL could guide patient management. This is a preview of subscription content, access via your institution

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about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Nadeu, F. _ et al_. Clinical impact of clonal and subclonal _TP53_, _SF3B1_, _BIRC3_, _NOTCH1_ and

_ATM_ mutations in chronic lymphocytic leukemia. _Blood_ http://dx.doi.org/10.1182/blood-2015-07-659144 (2016) Download references Authors * David Killock View author publications You can

also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Killock, D. Digging deep to reveal how the mutational

dynamics of CLL might inform patient management. _Nat Rev Clin Oncol_ 13, 202 (2016). https://doi.org/10.1038/nrclinonc.2016.29 Download citation * Published: 23 February 2016 * Issue Date:

April 2016 * DOI: https://doi.org/10.1038/nrclinonc.2016.29 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a

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