Prognostic score and cytogenetic risk classification for chronic lymphocytic leukemia patients: Center for International blood and marrow transplant research report

Haesook T. Kim, Kwang Woo Ahn, Zhen Huan Hu, Matthew S. Davids, Virginia O. Volpe, Joseph H. Antin, Mohamed L. Sorror, Mazyar Shadman, Oliver Press, Joseph Pidala, William Hogan, Robert Negrin, Steven Devine, Joseph Uberti, Edward Agura, Richard Nash, Jayesh Mehta, Joseph McGuirk, Stephen Forman, Amelia LangstonSergio A. Giralt, Miguel Angel Perales, Minoo Battiwalla, Gregory A. Hale, Robert Peter Gale, David I. Marks, Mehdi Hamadani, Sid Ganguly, Ulrike Bacher, Hillard Lazarus, Ran Reshef, Gerhard C. Hildebrandt, Yoshihiro Inamoto, Jean Yves Cahn, Melhem Solh, Mohamed A. Kharfan-Dabaja, Nilanjan Ghosh, Ayman Saad, Mahmoud Aljurf, Harry C. Schouten, Brian T. Hill, Attaphol Pawarode, Tamila Kindwall-Keller, Nakhle Saba, Edward A. Copelan, Sunita Nathan, Amer Beitinjaneh, Bipin N. Savani, Jan Cerny, Michael R. Grunwald, Jean Yared, Baldeep M. Wirk, Taiga Nishihori, Saurabh Chhabra, Richard F. Olsson, Asad Bashey, Usama Gergis, Uday Popat, Ronald Sobecks, Edwin Alyea, Wael Saber, Jennifer R. Brown

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: To develop a prognostic model and cytogenetic risk classification for previously treated patients with chronic lymphocytic leukemia (CLL) undergoing reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT). Experimental Design: We performed a retrospective analysis of outcomes of 606 patients with CLL who underwent RIC allogeneic HCT between 2008 and 2014 reported to the Center for International Blood and Marrow Transplant Research. Results: On the basis of multivariable models, disease status, comorbidity index, lymphocyte count, and white blood cell count at HCT were selected for the development of prognostic model. Using the prognostic score, we stratified patients into low-, intermediate-, high-, and very-high-risk [4-year progression-free survival (PFS) 58%, 42%, 33%, and 25%, respectively, P < 0.0001; 4-year overall survival (OS) 70%, 57%, 54%, and 38%, respectively, P < 0.0001]. We also evaluated karyotypic abnormalities together with del(17p) and found that del(17p) or 5 abnormalities showed inferior PFS. Using a multivariable model, we classified cytogenetic risk into low, intermediate, and high (P < 0.0001). When the prognostic score and cytogenetic risk were combined, patients with low prognostic score and low cytogenetic risk had prolonged PFS (61% at 4 years) and OS (75% at 4 years). Conclusions: In this large cohort of patients with previously treated CLL who underwent RIC HCT, we developed a robust prognostic scoring system of HCT outcomes and a novel cytogenetic-based risk stratification system. These prognostic models can be used for counseling patients, comparing data across studies, and providing a benchmark for future interventions. For future study, we will further validate these models for patients receiving targeted therapies prior to HCT.

Original languageEnglish (US)
Pages (from-to)5143-5155
Number of pages13
JournalClinical Cancer Research
Volume25
Issue number16
DOIs
StatePublished - Aug 15 2019

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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