Integrated CLL Scoring System, a New and Simple Index to Predict Time to Treatment and Overall Survival in Patients With Chronic Lymphocytic Leukemia

Clin Lymphoma Myeloma Leuk. 2015 Oct;15(10):612-20.e1-5. doi: 10.1016/j.clml.2015.06.001. Epub 2015 Jun 20.

Abstract

Introduction: Several prognostic factors have been identified to predict the outcome of patients with chronic lymphocytic leukemia (CLL), but only a few studies analyzed more markers together.

Patients and methods: Taking advantage of a population of 608 patients, we identified the strongest prognostic markers of survival and, subsequently, in a cohort of 212 patients we integrated data of cytogenetic lesions, IGHV mutational status, and CD38 expression in a new and easy scoring system we called the integrated CLL scoring system (ICSS). ICSS defines 3 groups of risk: (1) low risk (patients with 13q(-) or normal fluorescence in-situ hybridization analysis results, mutated IGHV, and CD38) (2) high risk (all 11q(-) or 17p(-) patients and/or all unmutated IGHV and CD38(+) patients); and (3) intermediate risk (all remaining patients).

Results: Using only these 3 already available prognostic factors, we were able to properly redefine patients and better predict the clinical course of the disease.

Conclusion: ICSS could become a useful tool for CLL patients' management.

Keywords: CD38; FISH; ICSS; IGHV; Prognostic models.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • ADP-ribosyl Cyclase 1 / genetics
  • ADP-ribosyl Cyclase 1 / metabolism
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / genetics
  • Biomarkers, Tumor / metabolism
  • Chromosomes, Human, Pair 11 / genetics
  • Chromosomes, Human, Pair 13 / genetics
  • DNA Mutational Analysis
  • Female
  • Humans
  • Immunoglobulin Heavy Chains / genetics
  • Kaplan-Meier Estimate
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality*
  • Leukemia, Lymphocytic, Chronic, B-Cell / pathology*
  • Leukemia, Lymphocytic, Chronic, B-Cell / therapy
  • Male
  • Membrane Glycoproteins / genetics
  • Membrane Glycoproteins / metabolism
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Proportional Hazards Models
  • Severity of Illness Index
  • Time-to-Treatment
  • Treatment Outcome
  • ZAP-70 Protein-Tyrosine Kinase / metabolism

Substances

  • Biomarkers, Tumor
  • Immunoglobulin Heavy Chains
  • Membrane Glycoproteins
  • ZAP-70 Protein-Tyrosine Kinase
  • CD38 protein, human
  • ADP-ribosyl Cyclase 1