Prognostic index may identify chronic lymphocytic leukemia patients who will not need treatment
(HealthDay)—A composite score can identify patients with chronic lymphocytic leukemia (CLL) with very low risk for requiring treatment, according to a study published online Jan. 14 in the European Journal of Haematology.
Christian Brieghel, M.D., Ph.D., from Rigshospitalet in Copenhagen, Denmark, and colleagues developed and validated a prognostic index to identify newly diagnosed CLL patients without need of treatment (WONT) by a training/validation approach based on data from 4,708 patients. Composite scores were derived from weighted hazards to define CLL-WONT risk groups.
The researchers observed independent associations for age (older than 65 years: 1 point), Binet stage (2 points), lactate dehydrogenase (>205 U/L: 1 point), absolute lymphocyte count (15 to 30 x 109/L: 1 point; >30 x 109/L: 2 points), β2-microglobulin (>4 mg/L: 1 point), IGHV mutation status (unmutated: 1 point), and 11q or 17q deletion (1 point) with shorter time to first treatment (TTFT). Five-year TTFT of 2 percent and 7 to 19 percent was seen for low-risk patients by internal validation and by external validation, respectively. The five-year TTFT was 10 percent for the 756 CLL-WONT low-risk patients, including all patients with complete scores, and it was 8 percent for the 704 patients who were low risk according to both CLL-WONT and the international prognostic index in CLL.
"We here present a novel prognostic index, CLL-WONT, enabling identification of patients with very low risk of ever requiring treatment," the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.
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