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Dates: February 2011 - February 2014
Funding: Health Innovation Challenge Fund
Collaborators: Dr Jenny Taylor, Dr Anna Schuh, Dr Samantha Knight, Oxford NIHR Biomedical Research Centre
Information: Sarah Wordsworth

Chronic lymphocytic leukemia (CLL) is the most common adult leukaemia. Most CLL patients are treated with chemoimmunotherapy as their first or second treatment. Although the majority respond well, there is a group of patients who will not respond or who will relapse within 2 years of treatment. CLL treatment costs are high, and the impact of unnecessary or inappropriate treatment can be considerable for both the patient themselves and also the NHS. FISH testing can provide some information on likely response to treatment, but this information is quite limited and many patients do not have access to FISH testing. Also, FISH testing only predicts lack of response in about a third of patients with refractory CLL. Hence, for most patients there is no way of predicting their response to chemoimmunotherapy before treatment starts.

 A targeted array test is being developed in Oxford to diagnose and direct chemoimmunotherapy treatment in CLL patients. This is a higher resolution test than FISH testing, and can better identify the genetic variations patients’ leukaemia cells which affect how they will respond to usual treatments. Current research by the Oxford NIHR Biomedical Research Centre is focused on providing evidence of the clinical utility of this higher resolution test. Alongside this clinical work, we are conducting a cost-effectiveness study which is considering both the higher costs of diagnosis as well as the potential savings that may be made by ensuring effective and appropriate treatment. This work is also being used as a case-study in a second HERC project, in which James Buchanan is investigating the methodological challenges associated with the health economic evaluation of genomic technologies.