Prognosis Assessment of Early-Stage Chronic Lymphocytic Leukemia: Are We Ready to Predict Clinical Evolution Without a Crystal Ball?

Marín, Isabel González-Gascón y; Muñoz‐Novas, Carolina; Figueroa, Iñigo Rúa; Hernández‐Sánchez, María; Rodríguez‐Vicente, Ana‐Eugenia; Quijada‐Álamo, Miguel; Pérez‐Carretero, Claudia; Moreno, Carol; Collado, Rosa; Espinet, Blanca; Puiggros, Anna; Heras, Natalia de las; Bosch, Francesc; Hernández, José-Ángel; Crónica, Grupo Español de Leucemia Linfática; Hematológica, Grupo Cooperativo Español de Citogenética

doi:10.1016/j.clml.2020.03.003

Cited by 11 publications

(15 citation statements)

References 29 publications

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“…Several prognostic indices have been developed for CLL which are specific to treatment settings and therapeutic classes, but do not include a measure of comorbidity. [24][25][26][27] While the CLL-CI does add prognostic information to the CLL-IPI for all therapies currently evaluated, assessment of the influence of comorbidities alongside other prognostic scales is needed. While prognostic factors should remain key for treatment decisions, clinical trial data from pivotal phase 3 trials with novel targeted agents versus chemoimmunotherapy should be reanalyzed with addition of CLL-CI to assess the optimal treatment for patients according to CLL-CI.…”

Section: Resultsmentioning

confidence: 99%

The CLL comorbidity index in a population-based cohort: a tool for clinical care and research

et al. 2022

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The chronic lymphocytic leukemia comorbidity index (CLL-CI) is an efficient, CLL-specific tool derived from the Cumulative Illness Rating Scale. The CLL-CI is based on the assessment of the organ systems found to be most strongly associated with event-free survival in CLL: vascular, upper gastrointestinal, and endocrine, at the time of initiation of CLL therapy. The CLL-CI categorizes patients into low, intermediate, and high risk groups. In the present study, we have employed the CLL-CI in a population-based cohort comprising 4 975 patients with CLL. We demonstrate that CLL-CI retains prognostic significance in this large cohort and is associated with overall survival and event-free survival from time of first therapy. Furthermore, CLL-CI associates with overall survival, event-free survival, and time to first treatment from diagnosis independently of the CLL International Prognostic Index. These findings support the use of the CLL-CI both in research and in clinical practice.

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Section: Resultsmentioning

confidence: 99%

The CLL comorbidity index in a population-based cohort: a tool for clinical care and research

et al. 2022

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“…42 In this comparative analysis, IPS-E emerged as the score which predicted TTFT most accurately. 42 Of note, IPS-E established that in early, asymptomatic patients, TP53 mutation is not an independent predictor of TTFT. This observation reinforces previous data that TP53 aberrancy in patients with early-stage asymptomatic disease should not be treated based on TP53 status alone.…”

Section: The Utility Of Prognosticating Patients With Early Cllmentioning

confidence: 88%

“…This observation reinforces previous data that TP53 aberrancy in patients with early-stage asymptomatic disease should not be treated based on TP53 status alone. 42,43 Finally, if early intervention with novel agents is ultimately shown to have a survival benefit in asymptomatic CLL in the future, IPS-E could then be a useful tool to select patients with a higher risk of disease progression who could benefit from earlier treatment.…”

Section: The Utility Of Prognosticating Patients With Early Cllmentioning

confidence: 99%

A perspective on prognostic models in chronic lymphocytic leukemia in the era of targeted agents

Molica

Seymour

Polliack

2021

Hematological Oncology

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Despite the increase in the number of prognostic models currently available for evaluating patients with chronic lymphocytic leukemia (CLL), their current application and utilization in clinical practice in the era of targeted agents is unclear. A critical reappraisal of recently developed prognostic models is presented in this review. The underlying CLL's genetic instability and changes in the host's health and comorbidities can all contribute to the acquisition of additional risk factors for adverse outcomes during the course of the disease. Therefore, available risk models solely based on pretreatment variables only partially predict patients' clinical outcome. A dynamic prognostic model that takes into account changes in the risk profile over time could indeed be useful in routine clinical practice. The next generation of risk assessment models should incorporate post-treatment and response biomarkers such as minimal residual disease. Finally, recent advances in the field of machine learning present novel opportunities to generate models capable of providing an individualized estimation of clinical outcomes in CLL. However, in the era of improved prognostic models, it is important to remember that these indices should supplement but not replace clinical expertise and medical decision-making.

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“…Different prognostic models have been proposed to assess the TTFT for patients with early-stage CLL; however, none has been universally established in routine clinical practice [4,5,13,14,27-30], five different prognostic indexes were compared in a cohort of patients with Binet A CLL from different institutions [31]. None of the scores was able to predict with absolute precision the evolution of early CLL patients.…”

Section: Prognostic Models In Early Cllmentioning

confidence: 99%

Chronic lymphocytic leukemia prognostic models in real life: still a long way off

Molica

2021

Expert Review of Hematology

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Prognosis Assessment of Early-Stage Chronic Lymphocytic Leukemia: Are We Ready to Predict Clinical Evolution Without a Crystal Ball?

Cited by 11 publications

References 29 publications

The CLL comorbidity index in a population-based cohort: a tool for clinical care and research

The CLL comorbidity index in a population-based cohort: a tool for clinical care and research

A perspective on prognostic models in chronic lymphocytic leukemia in the era of targeted agents

Chronic lymphocytic leukemia prognostic models in real life: still a long way off

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