Validation of the CLL-IPI and comparison with the MDACC prognostic index in newly diagnosed patients

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

doi:10.1182/blood-2016-07-728261

Cited by 58 publications

(49 citation statements)

References 5 publications

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“…From the database of the Department of Hematology, Hospital Clinic Barcelona, we retrieved 524 patients in whom information at diagnosis included age, clinical stage (Rai and Binet), IGHV mutational status, beta 2 ‐microglobulin (B2M), and fluorescence in situ hybridization (FISH)‐detected cytogenetic abnormalities. Diagnosis and criteria for starting therapy were those recommended by the International Workshop on CLL . FISH studies for del(11q), del(13q), and del(17p) and trisomy 12 were performed using the Vysis CLL probe kit (Abbott, Des Plaines, IL).…”

Section: Methodsmentioning

confidence: 99%

Chronic lymphocytic leukemia: A prognostic model comprising only two biomarkers (IGHV mutational status and FISH cytogenetics) separates patients with different outcome and simplifies the CLL‐IPI

et al. 2017

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Rai and Binet staging systems are important to predict the outcome of patients with chronic lymphocytic leukemia (CLL) but do not reflect the biologic diversity of the disease nor predict response to therapy, which ultimately shape patients' outcome. We devised a biomarkers-only CLL prognostic system based on the two most important prognostic parameters in CLL (i.e., IGHV mutational status and fluorescence in situ hybridization [FISH] cytogenetics), separating three different risk groups: (1) low-risk (mutated IGHV + no adverse FISH cytogenetics [del(17p), del(11q)]); (2) intermediate-risk (either unmutated IGHV or adverse FISH cytogenetics) and (3) high-risk (unmutated IGHV + adverse FISH cytogenetics). In 524 unselected subjects with CLL, the 10-year overall survival was 82% (95% CI 76%-88%), 52% (45%-62%), and 27% (17%-42%) for the low-, intermediate-, and high-risk groups, respectively. Patients with low-risk comprised around 50% of the series and had a life expectancy comparable to the general population. The prognostic model was fully validated in two independent cohorts, including 417 patients representative of general CLL population and 337 patients with Binet stage A CLL. The model had a similar discriminatory value as the CLL-IPI. Moreover, it applied to all patients with CLL independently of age, and separated patients with different risk within Rai or Binet clinical stages. The biomarkers-only CLL prognostic system presented here simplifies the CLL-IPI and could be useful in daily practice and to stratify patients in clinical trials.

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Section: Methodsmentioning

confidence: 99%

Chronic lymphocytic leukemia: A prognostic model comprising only two biomarkers (IGHV mutational status and FISH cytogenetics) separates patients with different outcome and simplifies the CLL‐IPI

et al. 2017

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“…7,8 Recently, an international prognostic index score that includes IGHV mutation status, along with age, clinical stage, mutations of the tumor suppressor gene TP53 , and serum beta-2 microglobulin level, was also found to predict time to first treatment and OS in CLL. 9–11 In this weighted model, the relative risk of IGHV mutational status is twice as much as age and clinical stage, and is second only to TP53 mutational status in importance. More simplified prognostic scores, consisting of only IGHV and TP53 mutational status, have similarly been shown to predict survival in patients with CLL.…”

Section: Ighv Testing In the Clinicmentioning

confidence: 99%

IGHV mutational status testing in chronic lymphocytic leukemia

Crombie

Davids

2017

American J Hematol

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As the therapeutic landscape for chronic lymphocytic leukemia (CLL) continues to expand, biological predictors of response to therapy are becoming increasingly important. One such predictive biomarker is the mutational status of the variable region of the immunoglobulin heavy chain (IGHV) gene, which is a powerful predictor of duration of response and overall survival with chemoimmunotherapy (CIT). As this test may influence choice of therapy between CIT and novel agents, it is critical that providers understand how mutational status is determined and the limitations of testing. Here, we describe the details of IGHV mutational status testing, highlighting the appropriate way to interpret this information and best apply it to the care of patients with CLL.

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“…2 This score has been externally validated (Supporting Information Table S1). 3,4 Recently, a Barcelona-Brno CLL consortium has proposed a prognostic model which is comprised of two biomarkers only (IGHV mutational status and FISH cytogenetics) with the aim of simplifying the CLL-IPI (Supporting Information Table S1). 5 This led to the identification of three patients categories (low-, intermediate-, and high-risk) with a different prognostic likelihood.…”

Section: Comparison Between the Cll-ipi And The Barcelona-brno Prognomentioning

confidence: 99%

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

et al. 2017

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Validation of the CLL-IPI and comparison with the MDACC prognostic index in newly diagnosed patients

Cited by 58 publications

References 5 publications

Chronic lymphocytic leukemia: A prognostic model comprising only two biomarkers (IGHV mutational status and FISH cytogenetics) separates patients with different outcome and simplifies the CLL‐IPI

Chronic lymphocytic leukemia: A prognostic model comprising only two biomarkers (IGHV mutational status and FISH cytogenetics) separates patients with different outcome and simplifies the CLL‐IPI

IGHV mutational status testing in chronic lymphocytic leukemia

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

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