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Ah7g7W-haematol.2019.228171.full.pdf (1.47 MB)

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

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posted on 2023-06-09, 20:42 authored by Jared A Cohen, Francesca Maria Rossi, Antonella Zucchetto, Riccardo Bomben, Lodovico Terzi-di-Bergamo, Kari G Rabe, Massimo Degan, Agostino Steffan, Jerry Polesel, Enrico Santinelli, Idanna Innocenti, Giovanna Cutrona, Giovanni D' Arena, Gabriele Pozzato, Christopher PepperChristopher Pepper, others
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.

History

Publication status

  • Published

File Version

  • Published version

Journal

Haematologica

ISSN

0390-6078

Publisher

Ferrata Storti Foundation

Volume

104

Department affiliated with

  • Clinical and Experimental Medicine Publications

Full text available

  • Yes

Peer reviewed?

  • Yes

Legacy Posted Date

2020-02-25

First Open Access (FOA) Date

2020-02-25

First Compliant Deposit (FCD) Date

2020-02-25

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