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The chronic lymphocytic leukemia international prognostic index predicts time to first treatment in early CLL: Independent validation in a prospective cohort of early stage patients
- Source :
- American Journal of Hematology. 91:1090-1095
- Publication Year :
- 2016
- Publisher :
- Wiley, 2016.
-
Abstract
- The chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) combines 5 parameters (age, clinical stage, TP53 status [normal vs. del(17p) and/or TP53 mutation], IGHV mutational status, serum β2-microglobulin) to predict survival and time-to-first-treatment (TTFT) in CLL patients. We performed an observational study in 337 prospectively collected, Binet stage A patients to validate the ability of the CLL-IPI to predict TTFT in an independent cohort of early stage CLL patients. The CLL-IPI score stratified Binet stage A patients into three subgroups with different outcome. Since the CLL-IPI was originally developed to predict survival, we next investigated the optimal cut-off score to predict TTFT in Binet stage A patients. Recursive partitioning analysis identified three subsets with scores of 0 (n = 139), 1 (n = 90), and ≥ 2(n = 108). The probability of remaining free from therapy 5 years after diagnosis was 85%, 67% and 46% in these three categories (P < 0.0001.; C-statistic:c = 0.72; 95% CI:0.58-0.81). This optimized CLL-IPI scoring for TTFT was subsequently validated in an independent cohort of Binet A patients from the Mayo Clinic (n = 525). The ability of either original or optimized CLL-IPI to predict TTFT was equivalent to other prognostic models specifically designed for this endpoint (2011 MDACC score and O-CLL1 score). Although originally developed to predict suvival, the CLL-IPI is useful for predicting TTFT in early stage CLL patients. Am. J. Hematol. 91:1090-1095, 2016. © 2016 Wiley Periodicals, Inc.
- Subjects :
- Oncology
medicine.medical_specialty
business.industry
Chronic lymphocytic leukemia
Recursive partitioning
Hematology
medicine.disease
03 medical and health sciences
Leukemia
0302 clinical medicine
International Prognostic Index
hemic and lymphatic diseases
030220 oncology & carcinogenesis
Internal medicine
Cohort
Immunology
medicine
Stage (cooking)
business
Prospective cohort study
IGHV@
030215 immunology
Subjects
Details
- ISSN :
- 03618609
- Volume :
- 91
- Database :
- OpenAIRE
- Journal :
- American Journal of Hematology
- Accession number :
- edsair.doi...........21f67f04b2ebf873caf976db9bb2ea83
- Full Text :
- https://doi.org/10.1002/ajh.24493