Everyone knows that p53 abnormalities bode ill for patients with CLL. Generally such leukemias are resistant to fludarabine, cyclophosphamide, chlorambucil, penatastatin, cladribine, and rituximab. Although responsive to high dose steroids and Campath and sometimes to Revlimid, most patients with this abnormality have very short survivals. The data on this come from randomized clinical trials like LRF CLL4. However, not all patients need treatment and these trials lack representation from unreated patients. So I have examined my database for patients with del 17p (the chromosomal abnormality that most commonly causes p53 deletion. Have a look at these graphs:
What they tell us is that patients with mutated IgVH genes who also have del 17p usually don't require treatment, just like other patients with mutated IgVH genes.