Comparison between the CLL‐IPI and the <scp>B</scp>arcelona‐<scp>B</scp>rno prognostic model: Analysis of 1299 newly diagnosed cases

Gentile, Massimo; Shanafelt, Tait D.; Mauro, Francesca Romana; Laurenti, Luca; Rossi, Davide; Molica, Stefano; Vincelli, Iolanda Donatella; Cutrona, Giovanna; Uccello, Giuseppina; Pepe, Sara; Vigna, Ernesto; Tripepi, Giovanni; Chaffee, Kari G.; Bossio, Sabrina; Recchia, Anna Grazia; Innocenti, Idanna; Pasquale, Raffaella; Neri, Antonino; Ferrarini, Manlio; Gaïdano, Gianluca; Foà, Robin; Morabito, Fortunato

doi:10.1002/ajh.24960

Cited by 18 publications

(12 citation statements)

References 7 publications

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“…Thus, the power of the analysis was insufficient for the multivariate analysis. However, our findings for the whole population was in line with previous reports 37 in showing a significant impact on outcome.…”

Section: Discussionsupporting

confidence: 93%

First-line therapy in chronic lymphocytic leukemia: a Swedish nation-wide real-world study on 1053 consecutive patients treated between 2007 and 2013

et al. 2018

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The aim of this study was to investigate long-term outcome following first-line therapy in consecutive chronic lymphocytic leukemia (CLL) patients in a well-defined geographic area: Sweden. All patients diagnosed with CLL (2007–2013) (n=3672) were identified from national registries, screening of patient files identified all (100%) treated first line (n=1053) and for those, an in-depth analysis was performed. End points were overall response rate, progression-free survival (PFS), overall survival (OS), and safety. Median age was 71 years; 53% had Rai stage III-IV and 97% had performance status grade 0–2. Fluorescence in situ hybridization (FISH) was performed in 57% of patients: 15% had del(17p). Chlorambucil + prednisone was used in 39% (5% also received rituximab). Fludarabine+cyclophosphamide+rituximab or fludarabine+cyclophosphamide was used in 43% and bendamustine + rituximab in 6%. Overall response rate was 64%; chlorambucil 43%, fludarabine+cyclophosphamide+rituximab 84%, fludarabine+cyclophosphamide 75% and bendamustine + rituximab 75%. Median PFS and OS was 24 and 58 months, respectively, both were significantly associated (multivariate analysis) with type of treatment, del(17p), performance status, gender, age and geographical region (OS only). Chlorambucil-treated patients had a median PFS and OS of only 9 and 33 months, respectively. Chlorambucil usage declined gradually throughout the study period, but one-third of patients still received chlorambucil + rituximab in 2013. Infections ≥grade III were significantly associated with treatment; chlorambucil 19% versus fludarabine+cyclophosphamide+rituximab 30%. Richter transformation occurred in 5.5% of the patients, equally distributed across therapies. This is the largest retrospective, real-world cohort of consecutive first-line treated CLL patients with a complete follow up. In elderly patients, an unmet need for more effective, well-tolerated therapies was identified.

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Section: Discussionsupporting

confidence: 93%

First-line therapy in chronic lymphocytic leukemia: a Swedish nation-wide real-world study on 1053 consecutive patients treated between 2007 and 2013

et al. 2018

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“…In addition, it has the advantage of the inclusion of patients with 11q- (associated with poor prognosis) [ 23 ], although in our series the most powerful PI was the CLL-IPI. However, our research confirms the results obtained in recent studies comparing these indexes and demonstrates the superiority of the CLL-IPI compared to the other models [ 13 , 21 , 30 ].…”

Section: Discussionsupporting

confidence: 92%

The International Prognostic Index for Patients with Chronic Lymphocytic Leukemia Has the Higher Value in Predicting Overall Outcome Compared with the Barcelona-Brno Biomarkers Only Prognostic Model and the MD Anderson Cancer Center Prognostic Index

Muñoz‐Novas

Poza-Santaella

Marín

et al. 2018

BioMed Research International

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In recent years, new prognostic indexes (PIs) for chronic lymphocytic leukemia (CLL), which include clinical, biological, and genetic variables, have been validated, highlighting the MD Anderson Cancer Center prognostic index (MDACC PI), the CLL-international prognostic index (CLL-IPI), and the Barcelona-Brno biomarkers only prognostic model. The aim of this study is to compare the utility of these PIs in a cohort of Spanish patients. A retrospective analysis of 696 unselected CLL patients newly diagnosed and previously untreated from different Spanish institutions was performed. The MDACC PI, the CLL-IPI, and the biomarkers only PI were applied to these patients, and a comparison of the three PIs was performed. With a median follow-up time of 46 months, 394 patients were alive and 187 had received treatment. The median overall survival (OS) was 173 months and the median time to first therapy (TTFT) was 32 months. Significant differences were obtained in OS and TTFT for all subgroups when applying these PIs, with the CLL-IPI being the one with the higher c-index (0.676 for OS and 0.757 for TTFT). The three PIs were able to discriminate patients in different prognostic subgroups. In our cohort, the CLL-IPI showed higher power in predicting TTFT and OS.

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“…The CLL-IPI scoring system has been gradually applied in clinical practice (8,9). The controlling significance of the CLL-IPI scoring system for TFS is not affected by the treatment approach, but whether it can still have a good guiding significance for OS, and the patient data to be included in the new drug treatment is demonstrated.…”

Section: Discusionmentioning

confidence: 99%

Chronic lymphocytic leukemia– Internationa Prognostic Index for Macedonian Patients with Chronic Lymphocytic Leukemia

Trajkova¹,

Čevreska²,

Ivanovski³

et al. 2019

IJCRR

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Introduction: Several prognostic factors have been identified to predict the outcome of patients with Chronic lymphocytic leukemia(CLL), but only a few studies investigated more markers together. To predict the time to first treatment (TFT) we integrated the data of traditional staging system, cytogenetic aberrations, and mutational status of immunoglobulin heavy chain variable region (IGHV) in Chronic lymphocytic leukemia-Internationa Prognostic Index(CLL-IPI). Aim of the study: To validate the prognostic value of chronic lymphocytic leukemia-international prognostic index (CLL-IPI) for Macedonian CLL patients. Material and Methods: The study is set up retrospectively and includes 75 patients with CLL diagnosed and treated at the University Clinic of Hematology for a period of time from January 2011 to January 2018. The median follow-up was 36 months (1-72 months).We recognized the prognostic markers of TFT,in line of definition that prognostic markers we incorporated the data of Rai staging system, most adverse cytogenetic marker and mutational status of immunoglobulin heavy chain. Results: The statistical data of the 75 patients shows that58.7% were males and 41.3% were females, with a median age of 64.3 (42-85) years old. The median TFS for low CLL-IPI (n=20), intermediate CLL-IPI (n=27), high risk CLL-IPI (n=15) and very high risk group (n=7) according to the CLL-IPI scoring system was 7.9, 7.6, 7.0 and 5.8 months, respectively. The median OS for low risk group was 58.5 for intermediate, high, and very high risk group was 37.8, 34.6 and 30 months, respectively. The estimated 5-year OS rate was 98.7%, 92%, 40% and 33%, respectively for low risk group intermediate, high, and very high risk group. Multivariate analysis indicated that del 17p (P< 0.00874) was independent prognostic factors of TFS. Conclusions: CLL-IPI is the powerful tool for risk stratification in Macedonian CLL patients and this system also provided treatment recommendations for the different patient risk subgroup.Though, it is unknown how newly developed CLL therapies and newly identified prognostic and predictive markers would be merged into this revised staging system.

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Comparison between the CLL‐IPI and the Barcelona‐Brno prognostic model: Analysis of 1299 newly diagnosed cases

Cited by 18 publications

References 7 publications

First-line therapy in chronic lymphocytic leukemia: a Swedish nation-wide real-world study on 1053 consecutive patients treated between 2007 and 2013

First-line therapy in chronic lymphocytic leukemia: a Swedish nation-wide real-world study on 1053 consecutive patients treated between 2007 and 2013

The International Prognostic Index for Patients with Chronic Lymphocytic Leukemia Has the Higher Value in Predicting Overall Outcome Compared with the Barcelona-Brno Biomarkers Only Prognostic Model and the MD Anderson Cancer Center Prognostic Index

Chronic lymphocytic leukemia– Internationa Prognostic Index for Macedonian Patients with Chronic Lymphocytic Leukemia

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