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

Abstract

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.

Chronic lymphocytic leukemia treatment algorithm 2018

“…The 5-year treatment-free survival in the Mayo validation cohort of previously untreated patients in the low, intermediate, high, and very-high risk CLL-IPI groups was 78%, 54%, 32%, and 0%, respectively. Other studies have also confirmed the ability of the CLL-IPI risk score in predicting time to first therapy in previously untreated CLL patients 31 – 33 .…”

Recent progress of prognostic biomarkers and risk scoring systems in chronic lymphocytic leukemia

“…Of note, the single-center study, which enrolled only 218 patients, can predict TTFT but not TTNT. In addition, CLL-IPI has a higher value in predicting the overall outcome [101]. To evaluate CLL-IPI in R/R CLL with novel therapy, Jacob D. Soumerai et al found that the value of each prognostic indicator might be different compared with untreated CLL [19].…”

From Biomarkers to Models in the Changing Landscape of Chronic Lymphocytic Leukemia: Evolve or Become Extinct

“…The most established today is the CLL-International Prognostic Index (CLL-IPI), which has demonstrated its ability to predict overall survival (OS), time to first therapy (TTFT) and progression-free survival (PFS) in the CIT setting [ 34 , 35 ]. It has also shown to predict TTFT in early-stage CLL [ 36 ] and community-based cohorts of patients [ 37 , 38 ]. However, its utility to predict PFS and even OS in patients treated with Tas is limited [ 39 ].…”