Prognostic nomogram and index for overall survival in previously untreated patients with chronic lymphocytic leukemia

Abstract

The clinical course for patients with chronic lymphocytic leukemia is extremely heterogeneous. The Rai and Binet staging systems have been used to risk-stratify patients; most patients present with early-stage disease. We evaluated a group of previously untreated patients with chronic lymphocytic leukemia (

First-line therapy with fludarabine compared with chlorambucil does not result in a major benefit for elderly patients with advanced chronic lymphocytic leukemia

“…Our data regarding the role of ␤ 2 -microglobulin are consistent with previously published data. [20][21][22][23] Because data of previous publications suggest that the prognostic impact of del(11q) is diminished in CLL patients above the age of 55 years, 24 ␤ 2 -microglobulin might be one of the most important prognostic factors in the elderly CLL population.…”

White blood cell count at diagnosis and immunoglobulin variable region gene mutations are independent predictors of treatment-free survival in young patients with stage A chronic lymphocytic leukemia

“…18 Moreover, age appears to affect more OS than TFS. 6,12,[18][19][20][21] Unmutated IGHV cases represented 36% of the overall cohort and 25% of stage A CLL. CD38+ (≥7%) cases were 26% and 20%, and ZAP-70+ (≥20%) were 32% and 27% in the two cohorts, respectively.…”

“…The WBC count is always an independent prognostic marker in multivariate analysis including purely clinical [19][20][21] or clinical-biological parameters of CLL. 6 However, this simple measure of tumor burden is often not considered, in contrast to the prognostic studies in acute leukemias, where it is invariably included.…”

Molecular Profiling in CLL

“…Clinicians may be better served using cheaper and more established markers of disease including lactate dehydrogenase and beta-2 microglobulin, which can be incorporated into nomograms to assess risk of progression. 41 Therefore, decision making in clinical practice should be made on the basis of clinical features of the disease, and the use of molecular profiles in the management of CLL remains a clinical trial question only. The only clear exception to this at present is in symptomatic patients with 17p del, in whom efforts should be made to treat these patients with agents that may act independently of p53.…”