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International prognostic score for asymptomatic early-stage chronic lymphocytic leukemia

A. Condoluci, L. Terzi di Bergamo, P. Langerbeins, MA. Hoechstetter, CD. Herling, L. De Paoli, J. Delgado, KG. Rabe, M. Gentile, M. Doubek, FR. Mauro, G. Chiodin, M. Mattsson, J. Bahlo, G. Cutrona, J. Kotaskova, C. Deambrogi, KE. Smedby, V....

. 2020 ; 135 (21) : 1859-1869. [pub] 20200521

Language English Country United States

Document type Journal Article, Multicenter Study, Observational Study, Research Support, Non-U.S. Gov't

Persistent link   https://www.medvik.cz/link/bmc21012571

Most patients with chronic lymphocytic leukemia (CLL) are diagnosed with early-stage disease and managed with active surveillance. The individual course of patients with early-stage CLL is heterogeneous, and their probability of needing treatment is hardly anticipated at diagnosis. We aimed at developing an international prognostic score to predict time to first treatment (TTFT) in patients with CLL with early, asymptomatic disease (International Prognostic Score for Early-stage CLL [IPS-E]). Individual patient data from 11 international cohorts of patients with early-stage CLL (n = 4933) were analyzed to build and validate the prognostic score. Three covariates were consistently and independently correlated with TTFT: unmutated immunoglobulin heavy variable gene (IGHV), absolute lymphocyte count higher than 15 × 109/L, and presence of palpable lymph nodes. The IPS-E was the sum of the covariates (1 point each), and separated low-risk (score 0), intermediate-risk (score 1), and high-risk (score 2-3) patients showing a distinct TTFT. The score accuracy was validated in 9 cohorts staged by the Binet system and 1 cohort staged by the Rai system. The C-index was 0.74 in the training series and 0.70 in the aggregate of validation series. By meta-analysis of the training and validation cohorts, the 5-year cumulative risk for treatment start was 8.4%, 28.4%, and 61.2% among low-risk, intermediate-risk, and high-risk patients, respectively. The IPS-E is a simple and robust prognostic model that predicts the likelihood of treatment requirement in patients with early-stage CLL. The IPS-E can be useful in clinical management and in the design of early intervention clinical trials.

Augusta Victoria Hospital Jerusalem Israel

Azienda Ospedaliera of Cosenza Cosenza Italy

Biotechnology Research Unit Aprigliano Cosenza Italy

Cancer Sciences Division University of Southampton Southampton United Kingdom

Center of Integrated Oncology Cologne Bonn and German CLL Study Group University of Cologne Cologne Germany

Central European Institute of Technology Masaryk University Brno Czech Republic

Department of Experimental Medicine University of Genoa Genoa Italy

Department of Internal Medicine 3 University Hospital of Ulm Ulm Germany

Department of Oncology and Hemato Oncology University of Milan Milan Italy

Division of Hematology Department of Translational Medicine University of Eastern Piedmont Novara Italy

Division of Hematology Sapienza University Rome Italy

Hospital Clinic Barcelona Spain

Hospital Munich Schwabing German CLL Study Group Munich Germany

Institute of Hematology and Oncology University of Barcelona Barcelona Spain

Institute of Oncology Research Università della Svizzera Italiana Bellinzona Switzerland

Interní Hematologická a Onkologická Klinika University Hospital Brno and Medical Faculty Masaryk University Brno Czech Republic

IRCCS Ospedale Policlinico San Martino Genoa Italy

Karolinska Institute Stockholm Sweden

Mayo Clinic Rochester MN

Oncology Institute of Southern Switzerland Bellinzona Switzerland

Southampton University Hospital Trust Southampton United Kingdom

The 1st Affiliated Hospital of Nanjing Medical University Jiangsu Province Hospital Nanjing China

University of Texas MD Anderson Cancer Center Houston TX

Uppsala University Hospital Uppsala Sweden

References provided by Crossref.org

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$a International prognostic score for asymptomatic early-stage chronic lymphocytic leukemia / $c A. Condoluci, L. Terzi di Bergamo, P. Langerbeins, MA. Hoechstetter, CD. Herling, L. De Paoli, J. Delgado, KG. Rabe, M. Gentile, M. Doubek, FR. Mauro, G. Chiodin, M. Mattsson, J. Bahlo, G. Cutrona, J. Kotaskova, C. Deambrogi, KE. Smedby, V. Spina, A. Bruscaggin, W. Wu, R. Moia, E. Bianchi, B. Gerber, E. Zucca, S. Gillessen, M. Ghielmini, F. Cavalli, G. Stussi, MA. Hess, TS. Baumann, A. Neri, M. Ferrarini, R. Rosenquist, F. Forconi, R. Foà, S. Pospisilova, F. Morabito, S. Stilgenbauer, H. Döhner, SA. Parikh, WG. Wierda, E. Montserrat, G. Gaidano, M. Hallek, D. Rossi
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