Evaluation of the CLL-IPI in relapsed and refractory chronic lymphocytic leukemia in idelalisib phase-3 trials

Autor: Andrew D. Zelenetz, Ronald L. Dubowy, Jeffrey A. Jones, Jacob D. Soumerai, Richard R. Furman, Ai Ni, Jeffrey P. Sharman, Julie Huang, Michael Hallek, Lyndah Dreiling, Adeboye H. Adewoye, Guan Xing
Rok vydání: 2018
Předmět:
Adult
Male
Oncology
Cancer Research
medicine.medical_specialty
Chronic lymphocytic leukemia
Immunoglobulin Variable Region
Kaplan-Meier Estimate
Relapsed CLL
Models
Biological
Risk Assessment
Article
03 medical and health sciences
0302 clinical medicine
immune system diseases
hemic and lymphatic diseases
Internal medicine
Antineoplastic Combined Chemotherapy Protocols
medicine
Humans
Multicenter Studies as Topic
In patient
neoplasms
Aged
Quinazolinones
Aged
80 and over
business.industry
Hematology
Middle Aged
Prognosis
medicine.disease
Leukemia
Lymphocytic
Chronic
B-Cell
Lymphoma
Leukemia
Treatment Outcome
Clinical Trials
Phase III as Topic
Drug Resistance
Neoplasm
Purines
030220 oncology & carcinogenesis
Prognostic model
Female
Neoplasm Recurrence
Local
Refractory Chronic Lymphocytic Leukemia
Immunoglobulin Heavy Chains
business
Idelalisib
Follow-Up Studies
030215 immunology
Zdroj: Leuk Lymphoma
ISSN: 1029-2403
1042-8194
DOI: 10.1080/10428194.2018.1540782
Popis: The CLL-IPI is a risk-weighted prognostic model for previously untreated patients with chronic lymphocytic leukemia (CLL), but has not been evaluated in patients with relapsed CLL or on novel therapies. We evaluated the CLL-IPI in 897 patients with relapsed/refractory CLL in 3 randomized trials testing idelalisib (PI3Kδ inhibitor). The CLL-IPI identified patients as low (2.2%), intermediate (12.8%), high (48.7%), and very high (36.2%) risk, and was prognostic for survival (log-rank p65, β2-microglobulin >3.5mg/L, unmutated immunoglobulin heavy chain variable region gene, and deletion 17p/TP53 mutation were independently prognostic, but Rai I-IV or Binet B/C was not. The CLL-IPI is prognostic for survival in relapsed CLL and with idelalisib therapy. However, low/intermediate risk is uncommon, and regression parameters of individual factors in this risk-weighted model appear different in relapsed CLL. Reassessment of the weighting of the individual variables might optimize the model in this setting.
Databáze: OpenAIRE
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