Prognostic model for newly diagnosed CLL patients in Binet stage A: results of the multicenter, prospective CLL1 trial of the German CLL study group
| Autor: | Bertold Emmerich, Werner Freier, Martin Bentz, Hartmut Döhner, Lothar Müller, Kirsten Fischer, Manuela Hoechstetter, Dirk Winkler, Sandra Robrecht, Georg Hopfinger, Carmen D. Herling, Ilona Blau, Frank Hartmann, Georg Jacobs, Barbara Eichhorst, Ulrich Jäger, Jasmin Bahlo, Ursula Vehling-Kaiser, Maria Elisabeth Goebeler, Michael J. Eckart, Clemens M. Wendtner, Andreas Bühler, Michael Starck, Wolfgang Abenhardt, Hans Jürgen Hurtz, Harald Fuss, Stephan Stilgenbauer, Raymonde Busch, Michael Hallek |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Oncology Cancer Research medicine.medical_specialty Multivariate analysis Population Newly diagnosed Time-to-Treatment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols Biomarkers Tumor medicine Humans Prospective Studies Stage (cooking) education Aged education.field_of_study business.industry Hematology Middle Aged Prognosis Leukemia Lymphocytic Chronic B-Cell Survival Rate Clinical trial 030104 developmental biology 030220 oncology & carcinogenesis Mutation Cohort Disease Progression Prognostic model Female IGHV@ business Follow-Up Studies |
| Zdroj: | Leukemia. 34:1038-1051 |
| ISSN: | 1476-5551 0887-6924 |
| Popis: | The heterogeneity of early stage CLL challenges prognostication, and refinement of prognostic indices for risk-adapted management in this population is essential. The aim of the multicenter, prospective CLL1 trial was to explore a novel prognostic model (CLL1-PM) developed to identify risk groups, separating patients with favorable from others with dismal prognosis. A cohort of 539 clinically, biochemically, and genetically characterized Binet stage A patients were observed until progression, first-line treatment, or death. Multivariate analysis identified six independent factors associated with overall survival (OS) and time-to-first treatment (TTFT): del(17p), unmutated IGHV, del(11q), ß2-microglobulin3.5 mg/dL, lymphocyte doubling time (LDT)12 months, and age60 years. These factors were integrated into the CLL1-PM, which stratified patients into four risk groups. The CLL1-PM was prognostic for OS and TTFT, e.g., the risk of treatment at 5 years was 85.9, 51.8, 27.6, and 11.3% for very low (0-1.5), low (2-4), high (4.5-6.5), and very high-risk (7-14) scores, respectively (P 0.001). Notably, in addition to factors comprising CLL-IPI, we substantiated del(11q) and LDT as prognostic factors in early CLL. Altogether, our findings would be useful to effectively stratify Binet stage A patients, particularly within the scope of clinical trials evaluating novel agents. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink