“…105,106 Immunogenetic studies have shown a biased usage of certain IGHV genes (IGHV3-21, IGHV4-34, IGHV1-8, and IGHV3-23), suggesting antigen-driven selection, whereas completely unmutated IGHV genes are detected in~30% of the cases, which have a worse prognosis than cases with IGH somatic hypermutations. 107,108 The genomic landscape of MCL is heterogeneous, and comprises mutations in genes involved in DNA damage response (ATM and TP53) and Notch signalling (NOTCH1 and NOTCH2), and in genes affecting RNA metabolism and splicing (EWSR1, DAZAP1, and HNRNPH1). Mutations in TP53, SMARCA4, CELSR3, CCND1 and KMT2D have been found to negatively affect the response to venetoclax-based therapies.…”