Condoluci, Adalgisa, di Bergamo, Lodovico Terzi, Langerbeins, Petra, Hoechstetter, Manuela A., Herling, Carmen D., De Paoli, Lorenzo, Delgado, Julio, Rabe, Kari G., Gentile, Massimo ORCID: 0000-0002-5256-0726, Doubek, Michael, Mauro, Francesca R., Chiodin, Giorgia, Mattsson, Mattias ORCID: 0000-0002-9510-8801, Bahlo, Jasmin, Cutrona, Giovanna ORCID: 0000-0002-3335-1101, Kotaskova, Jana, Deambrogi, Clara, Smedby, Karin E., Spina, Valeria, Bruscaggin, Alessio, Wu, Wei, Moia, Riccardo, Bianchi, Elena, Gerber, Bernhard, Zucca, Emanuele, Gillessen, Silke ORCID: 0000-0001-5746-6555, Ghielmini, Michele, Cavalli, Franco, Stussi, Georg, Hess, Mark A., Baumann, Tycho S., Neri, Antonino, Ferrarini, Manlio, Rosenquist, Richard, Forconi, Francesco, Foa, Robin, Pospisilova, Sarka, Morabito, Fortunato, Stilgenbauer, Stephan, Doehner, Hartmut, Parikh, Sameer A., Wierda, William G., Montserrat, Emili, Gaidano, Gianluca, Hallek, Michael and Rossi, Davide (2020). International prognostic score for asymptomatic early-stage chronic lymphocytic leukemia. Blood, 135 (21). S. 1859 - 1870. WASHINGTON: AMER SOC HEMATOLOGY. ISSN 1528-0020

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Abstract

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 x 10(9)/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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Condoluci, AdalgisaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
di Bergamo, Lodovico TerziUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Langerbeins, PetraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoechstetter, Manuela A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herling, Carmen D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
De Paoli, LorenzoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Delgado, JulioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rabe, Kari G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gentile, MassimoUNSPECIFIEDorcid.org/0000-0002-5256-0726UNSPECIFIED
Doubek, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mauro, Francesca R.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Chiodin, GiorgiaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mattsson, MattiasUNSPECIFIEDorcid.org/0000-0002-9510-8801UNSPECIFIED
Bahlo, JasminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cutrona, GiovannaUNSPECIFIEDorcid.org/0000-0002-3335-1101UNSPECIFIED
Kotaskova, JanaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deambrogi, ClaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Smedby, Karin E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Spina, ValeriaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bruscaggin, AlessioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wu, WeiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Moia, RiccardoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bianchi, ElenaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gerber, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zucca, EmanueleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gillessen, SilkeUNSPECIFIEDorcid.org/0000-0001-5746-6555UNSPECIFIED
Ghielmini, MicheleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Cavalli, FrancoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stussi, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hess, Mark A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baumann, Tycho S.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Neri, AntoninoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ferrarini, ManlioUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rosenquist, RichardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Forconi, FrancescoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Foa, RobinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Pospisilova, SarkaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Morabito, FortunatoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stilgenbauer, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doehner, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Parikh, Sameer A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wierda, William G.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Montserrat, EmiliUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gaidano, GianlucaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hallek, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rossi, DavideUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-333142
DOI: 10.1182/blood.2019003453
Journal or Publication Title: Blood
Volume: 135
Number: 21
Page Range: S. 1859 - 1870
Date: 2020
Publisher: AMER SOC HEMATOLOGY
Place of Publication: WASHINGTON
ISSN: 1528-0020
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
1ST TREATMENT; BINET STAGE; CLL; GUIDELINES; SURVIVAL; MODEL; INDEX; TIME; MUTATIONS; DIAGNOSISMultiple languages
HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/33314

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