Searching for surrogates for IGHV mutations in chronic lymphocytic leukemia

As the assay for IGHV mutations has been standardized the level of difficulty has diminished and as greater numbers of cases have been assessed it has become clear that there is even more information to be gathered from the study of the sequence of IGHV genes. It has been recognized that stereotypy within CLL is associated with more specific clinical features than mere longevity and an even greater heterogeneity has been revealed. It seems clear that the search for surrogacy is futile and that IGHV mutational status should become a routine investigation in CLL.