Prognostic Score Predicts Time to First Treatment in Leukemia

Prognostic score for early-stage CLL based on genetic test, lymphocyte count, lymph node status

needle with a drop at the end

WEDNESDAY, April 15, 2020 (HealthDay News) -- An international prognostic score (IPS-E) can predict time to first treatment (TTFT) for chronic lymphocytic leukemia (CLL) patients with early, asymptomatic disease, according to a study published online April 8 in Blood.

Adalgisa Condoluci, M.D., from the Institute of Oncology Research in Bellinzona, Switzerland, and colleagues analyzed individual patient data from 11 international cohorts of patients (4,933 patients) to build and validate a prognostic score to predict TTFT for patients with early asymptomatic CLL.

The researchers found that unmutated IGHV genes, absolute lymphocyte count >15 × 109/L, and presence of palpable lymph nodes were consistently and independently associated with TTFT. The IPS-E was the sum of the covariates (1 point each) and differentiated patients into low, intermediate, and high-risk (scores 0, 1, and 2 to 3, respectively), with distinct TTFT. In nine cohorts staged by the Binet system and one cohort staged by the Rai system, the score accuracy was validated. The C-index was 0.74 and 0.70 in the training series and the aggregate of validation series, respectively. Among low-, intermediate-, and high-risk patients, the five-year cumulative risk for treatment start was 8.4, 28.4, and 61.2 percent, respectively, by meta-analysis of the training and validation cohorts.

"The IPS-E warrants prospective evaluation and can be regarded as a building block to which newly discovered independent outcome predictors for patients with early stage CLL could be added," the authors write.

Several authors disclosed financial ties to the biopharmaceutical industry.

Abstract/Full Text

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Published on April 15, 2020

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