The chronic lymphocytic leukemia international prognostic index predicts time to first treatment in early CLL: Independent validation in a prospective cohort of early stage patients

Stefano Molica, Tait D. Shanafelt, Diana Giannarelli, Massimo Gentile, Rosanna Mirabelli, Giovanna Cutrona, Luciano Levato, Nicola Di Renzo, Francesco Di Raimondo, Caterina Musolino, Francesco Angrilli, Angelo Famà, Anna Grazia Recchia, Kari G. Chaffee, Antonino Neri, Neil Elliot Kay, Manlio Ferrarini, Fortunato Morabito

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Abstract

The chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) combines 5 parameters (age, clinical stage, TP53 status [normal vs. del(17p) and/or TP53 mutation], IGHV mutational status, serum β2-microglobulin) to predict survival and time-to-first-treatment (TTFT) in CLL patients. We performed an observational study in 337 prospectively collected, Binet stage A patients to validate the ability of the CLL-IPI to predict TTFT in an independent cohort of early stage CLL patients. The CLL-IPI score stratified Binet stage A patients into three subgroups with different outcome. Since the CLL-IPI was originally developed to predict survival, we next investigated the optimal cut-off score to predict TTFT in Binet stage A patients. Recursive partitioning analysis identified three subsets with scores of 0 (n = 139), 1 (n = 90), and ≥ 2(n = 108). The probability of remaining free from therapy 5 years after diagnosis was 85%, 67% and 46% in these three categories (P < 0.0001.; C-statistic:c = 0.72; 95% CI:0.58-0.81). This optimized CLL-IPI scoring for TTFT was subsequently validated in an independent cohort of Binet A patients from the Mayo Clinic (n = 525). The ability of either original or optimized CLL-IPI to predict TTFT was equivalent to other prognostic models specifically designed for this endpoint (2011 MDACC score and O-CLL1 score). Although originally developed to predict suvival, the CLL-IPI is useful for predicting TTFT in early stage CLL patients. Am. J. Hematol. 91:1090–1095, 2016.

Original languageEnglish (US)
Pages (from-to)1090-1095
Number of pages6
JournalAmerican Journal of Hematology
Volume91
Issue number11
DOIs
StatePublished - Nov 1 2016

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Keywords

  • leukemia

ASJC Scopus subject areas

  • Hematology

Cite this

Molica, S., Shanafelt, T. D., Giannarelli, D., Gentile, M., Mirabelli, R., Cutrona, G., Levato, L., Di Renzo, N., Di Raimondo, F., Musolino, C., Angrilli, F., Famà, A., Recchia, A. G., Chaffee, K. G., Neri, A., Kay, N. E., Ferrarini, M., & Morabito, F. (2016). The chronic lymphocytic leukemia international prognostic index predicts time to first treatment in early CLL: Independent validation in a prospective cohort of early stage patients. American Journal of Hematology, 91(11), 1090-1095. https://doi.org/10.1002/ajh.24493