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

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• 作者：Stefano Molica ; Tait D. Shanafelt ; Diana Giannarelli ; Massimo Gentile ; Rosanna Mirabelli ; Giovanna Cutrona ; Luciano Levato ; Nicola Di Renzo ; Francesco Di Raimondo ; Caterina Musolino ; Francesco Angrilli ; Angelo Famà ; Anna Grazia Recchia ; Kari G. Chaffee ; Antonino Neri ; Neil E. Kay ; Manlio Ferrarini and Fortunato Morabito
• 刊名：American Journal of Hematology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：91
• 期：11
• 页码：1090-1095
• 全文大小：712K
• ISSN：1096-8652

文摘

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.