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Identifying patient...
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Brieghel, ChristianRigshosp, Dept Hematol, Copenhagen, Denmark
(author)
Identifying patients with chronic lymphocytic leukemia without need of treatment : End of endless watch and wait?
- Article/chapterEnglish2022
Publisher, publication year, extent ...
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2022-01-22
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John Wiley & Sons,2022
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electronicrdacarrier
Numbers
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LIBRIS-ID:oai:DiVA.org:uu-484821
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-484821URI
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https://doi.org/10.1111/ejh.13743DOI
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http://kipublications.ki.se/Default.aspx?queryparsed=id:148588749URI
Supplementary language notes
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Language:English
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Summary in:English
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Subject category:ref swepub-contenttype
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Subject category:art swepub-publicationtype
Notes
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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.
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Added entries (persons, corporate bodies, meetings, titles ...)
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Galle, VeerleGhent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
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Agius, RudiRigshosp, Dept Hematol, Copenhagen, Denmark
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Da Cunha-Bang, CasparRigshosp, Dept Hematol, Copenhagen, Denmark
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Andersen, Michael A.Rigshosp, Dept Hematol, Copenhagen, Denmark
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Vlummens, PhilipGhent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
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Mattsson, MattiasUppsala universitet,Institutionen för immunologi, genetik och patologi,Uppsala Univ Hosp, Dept Hematol, Uppsala, Sweden(Swepub:uu)matma431
(author)
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Rosenquist, RichardKarolinska Institutet
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Smedby, Karin E.Karolinska Institutet
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Herling, Carmen D.Uniklin Koln, Dept Internal Med, Cologne, Germany
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Bahlo, JasminUniklin Koln, Dept Internal Med, Cologne, Germany
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Hallek, MichaelUniklin Koln, Dept Internal Med, Cologne, Germany
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Lundgren, Jens D.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, FritzGhent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
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Niemann, Carsten U.Rigshosp, Dept Hematol, Copenhagen, Denmark
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Rigshosp, Dept Hematol, Copenhagen, DenmarkGhent Univ Hosp, Dept Clin Hematol, Ghent, Belgium
(creator_code:org_t)
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In:European Journal of Haematology: John Wiley & Sons108:5, s. 369-3780902-44411600-0609
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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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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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