TY - JOUR
T1 - A laboratory-based scoring system predicts early treatment in Rai 0 chronic lymphocytic leukemia
AU - Cohen, Jared A.
AU - Rossi, Francesca Maria
AU - Zucchetto, Antonella
AU - Bomben, Riccardo
AU - Terzi-Di-Bergamo, Lodovico
AU - Rabe, Kari G.
AU - Degan, Massimo
AU - Steffan, Agostino
AU - Polesel, Jerry
AU - Santinelli, Enrico
AU - Innocenti, Idanna
AU - Cutrona, Giovanna
AU - D'Arena, Giovanni
AU - Pozzato, Gabriele
AU - Zaja, Francesco
AU - Chiarenza, Annalisa
AU - Rossi, Davide
AU - Di Raimondo, Francesco
AU - Laurenti, Luca
AU - Gentile, Massimo
AU - Morabito, Fortunato
AU - Neri, Antonino
AU - Ferrarini, Manlio
AU - Fegan, Christopher D.
AU - Pepper, Christopher J.
AU - Poeta, Giovanni Del
AU - Parikh, Sameer A.
AU - Kay, Neil E.
AU - Gattei, Valter
PY - 2019
Y1 - 2019
N2 - We present a laboratory-based prognostic calculator (designated CRO score) to risk stratify treatment-free survival in early stage (Rai 0) chronic lymphocytic leukemia developed using a training-validation model in a series of 1,879 cases from Italy, the United Kingdom and the United States. By means of regression analysis, we identified five prognostic variables with weighting as follows: deletion of the short arm of chromosome 17 and unmutated immunoglobulin heavy chain gene status, 2 points; deletion of the long arm of chromosome 11, trisomy of chromosome 12, and white blood cell count>32.0x103/microliter, 1 point. Low, intermediate and high-risk categories were established by recursive partitioning in a training cohort of 478 cases, and then validated in four independent cohorts of 144/395/540/322 cases, as well as in the composite validation cohort. Concordance indices were 0.75 in the training cohort and ranged from 0.63 to 0.74 in the four validation cohorts (0.69 in the composite validation cohort). These findings advocate potential application of our novel prognostic calculator to better stratify early-stage chronic lymphocytic leukemia, and aid case selection in risk-adapted treatment for early disease. Furthermore, they support immunocytogenetic analysis in Rai 0 chronic lymphocytic leukemia being performed at the time of diagnosis to aid prognosis and treatment, particularly in today's chemo-free era.
AB - We present a laboratory-based prognostic calculator (designated CRO score) to risk stratify treatment-free survival in early stage (Rai 0) chronic lymphocytic leukemia developed using a training-validation model in a series of 1,879 cases from Italy, the United Kingdom and the United States. By means of regression analysis, we identified five prognostic variables with weighting as follows: deletion of the short arm of chromosome 17 and unmutated immunoglobulin heavy chain gene status, 2 points; deletion of the long arm of chromosome 11, trisomy of chromosome 12, and white blood cell count>32.0x103/microliter, 1 point. Low, intermediate and high-risk categories were established by recursive partitioning in a training cohort of 478 cases, and then validated in four independent cohorts of 144/395/540/322 cases, as well as in the composite validation cohort. Concordance indices were 0.75 in the training cohort and ranged from 0.63 to 0.74 in the four validation cohorts (0.69 in the composite validation cohort). These findings advocate potential application of our novel prognostic calculator to better stratify early-stage chronic lymphocytic leukemia, and aid case selection in risk-adapted treatment for early disease. Furthermore, they support immunocytogenetic analysis in Rai 0 chronic lymphocytic leukemia being performed at the time of diagnosis to aid prognosis and treatment, particularly in today's chemo-free era.
KW - Chronic Lymphocytic Leukemia
KW - Cytogenetics and Molecular Genetics
KW - Immunophenotyping
KW - Chronic Lymphocytic Leukemia
KW - Cytogenetics and Molecular Genetics
KW - Immunophenotyping
UR - http://hdl.handle.net/10807/144463
U2 - 10.3324/haematol.2019.228171
DO - 10.3324/haematol.2019.228171
M3 - Article
SN - 0390-6078
SP - N/A-N/A
JO - Haematologica
JF - Haematologica
ER -