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Prognostic Score Predicts Time to First Treatment in Leukemia

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

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.

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