A laboratory-based scoring system predicts early treatment in Rai 0 chronic lymphocytic leukemia

Cohen, Jared A, Rossi, Francesca Maria, Zucchetto, Antonella, Bomben, Riccardo, Terzi-di-Bergamo, Lodovico, Rabe, Kari G, Degan, Massimo, Steffan, Agostino, Polesel, Jerry, Santinelli, Enrico, Innocenti, Idanna, Cutrona, Giovanna, D' Arena, Giovanni, Pozzato, Gabriele, Pepper, Christopher J and others, (2019) A laboratory-based scoring system predicts early treatment in Rai 0 chronic lymphocytic leukemia. Haematologica, 104. ISSN 0390-6078

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We present a laboratory-based prognostic calculator (designated CRO score) to risk stratify treatment-free survival in early stage (Rai 0) chronic lymphocytic leukemia developed using a training-validation model in a series of 1,879 cases from Italy, the United Kingdom and the United States. By means of regression analysis, we identified five prognostic variables with weighting as follows: deletion of the short arm of chromosome 17 and unmutated immunoglobulin heavy chain gene status, 2 points; deletion of the long arm of chromosome 11, trisomy of chromosome 12, and white blood cell count>32.0x103/microliter, 1 point. Low, intermediate and high-risk categories were established by recursive partitioning in a training cohort of 478 cases, and then validated in four independent cohorts of 144/395/540/322 cases, as well as in the composite validation cohort. Concordance indices were 0.75 in the training cohort and ranged from 0.63 to 0.74 in the four validation cohorts (0.69 in the composite validation cohort). These findings advocate potential application of our novel prognostic calculator to better stratify early-stage chronic lymphocytic leukemia, and aid case selection in risk-adapted treatment for early disease. Furthermore, they support immunocytogenetic analysis in Rai 0 chronic lymphocytic leukemia being performed at the time of diagnosis to aid prognosis and treatment, particularly in today's chemo-free era.

Item Type: Article
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology Including cancer and carcinogens > RC0261 Cancer and other malignant neoplasms > RC0267 Research. Experimentation
Depositing User: Christopher Pepper
Date Deposited: 25 Feb 2020 08:16
Last Modified: 25 Feb 2020 08:30
URI: http://sro.sussex.ac.uk/id/eprint/90077

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