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Identifying patient...
Identifying patients with chronic lymphocytic leukemia without need of treatment : End of endless watch and wait?
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- Brieghel, Christian (author)
- Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Galle, Veerle (author)
- Ghent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
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- Agius, Rudi (author)
- Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Da Cunha-Bang, Caspar (author)
- Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Andersen, Michael A. (author)
- Rigshosp, Dept Hematol, Copenhagen, Denmark
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- Vlummens, Philip (author)
- Ghent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
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- Mattsson, Mattias (author)
- Uppsala universitet,Institutionen för immunologi, genetik och patologi,Uppsala Univ Hosp, Dept Hematol, Uppsala, Sweden
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- Rosenquist, Richard (author)
- Karolinska Institutet
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- Smedby, Karin E. (author)
- Karolinska Institutet
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- Herling, Carmen D. (author)
- Uniklin Koln, Dept Internal Med, Cologne, Germany
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- Bahlo, Jasmin (author)
- Uniklin Koln, Dept Internal Med, Cologne, Germany
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- Hallek, Michael (author)
- Uniklin Koln, Dept Internal Med, Cologne, Germany
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- Lundgren, Jens D. (author)
- Copenhagen Univ Hosp, Rigshosp, Ctr Hlth Immun & Infect Dis CHIP, Copenhagen, Denmark.;Univ Copenhagen, Fac Hlth Sci, Dept Clin Med, Copenhagen, Denmark
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- Offner, Fritz (author)
- Ghent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
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- Niemann, Carsten U. (author)
- Rigshosp, Dept Hematol, Copenhagen, Denmark
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(creator_code:org_t)
- 2022-01-22
- 2022
- English.
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In: European Journal of Haematology. - : John Wiley & Sons. - 0902-4441 .- 1600-0609. ; 108:5, s. 369-378
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Abstract
Subject headings
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- Introduction Early-stage chronic lymphocytic leukemia (CLL) challenges specialized management and follow-up.Methods We developed and validated a prognostic index to identify newly diagnosed patients without need of treatment (CLL-WONT) by a training/validation approach using data on 4708 patients. Composite scores derived from weighted hazards by multivariable analysis defined CLL-WONT risk groups.Results Age (>65 years: 1 point), Binet stage (B: 2 points), lactate dehydrogenase (LDH) (>205 U/L: 1 point), absolute lymphocyte count (15-30 x 10(9)/L: 1 point; >30 x 10(9)/L; 2 points), beta 2-microglobulin (>4 mg/L: 1 point), IGHV mutation status (unmutated: 1 point), and 11q or 17p deletion (1 point) were independently associated with shorter time to first treatment (TTFT). Low-risk patients demonstrated 5-year TTFT of 2% by internal validation, but 7-19% by external validation. Including all patients with complete scores, the 5-year TTFT was 10% for the 756 (39%) CLL-WONT low-risk patients, and the 704 (37%) patients who were both CLL-WONT and CLL-IPI low risk demonstrated even lower 5-year TTFT (8%).Conclusion We have adopted the CLL-WONT at an institution covering 1 800 000 individuals to allow patients with both low-risk CLL-WONT and CLL-IPI to be managed by primary healthcare providers, thereby prioritizing specialized hematology services for patients in dire need.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Hematologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Hematology (hsv//eng)
Keyword
- CLL
- CLL-WONT
- follow up
- low risk
- prognostic index
- therapy
- watch and wait
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Brieghel, Christ ...
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Galle, Veerle
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Agius, Rudi
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Da Cunha-Bang, C ...
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Andersen, Michae ...
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Vlummens, Philip
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show more...
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Mattsson, Mattia ...
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Rosenquist, Rich ...
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Smedby, Karin E.
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Herling, Carmen ...
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Bahlo, Jasmin
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Hallek, Michael
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Lundgren, Jens D ...
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Offner, Fritz
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Niemann, Carsten ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Hematology
- Articles in the publication
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European Journal ...
- By the university
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Uppsala University
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Karolinska Institutet