Comparative assessment of prognostic models in chronic lymphocytic leukemia: evaluation in Indian cohort.

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  • Additional Information
    • Source:
      Publisher: Springer Verlag Country of Publication: Germany NLM ID: 9107334 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-0584 (Electronic) Linking ISSN: 09395555 NLM ISO Abbreviation: Ann Hematol Subsets: MEDLINE
    • Publication Information:
      Publication: Berlin : Springer Verlag
      Original Publication: Berlin ; New York : Springer International, c1991-
    • Subject Terms:
      Models, Biological*; Leukemia, Lymphocytic, Chronic, B-Cell/*mortality; Aged ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Immunoglobulin Heavy Chains ; India/epidemiology ; Leukemia, Lymphocytic, Chronic, B-Cell/genetics ; Leukemia, Lymphocytic, Chronic, B-Cell/therapy ; Middle Aged ; Mutation ; Survival Rate ; beta 2-Microglobulin
    • Abstract:
      Prognostic indices combining several clinical and laboratory parameters have been proposed for prognostication in chronic lymphocytic leukemia (CLL). Recently, international consortium on CLL proposed an international prognostic index (CLL-IPI) integrating clinical, molecular, and genetic parameters. The present study was designed to evaluate the reproducibility of CLL-IPI in Indian CLL cohort. The prognostic ability of CLL-IPI in terms of overall survival (OS) and time to first treatment (TTFT) was investigated in treatment-naive CLL patients and also compared with other existing prognostic scores. For assigning scores, clinical and laboratory details were obtained from medical records, and IGHV gene mutation status, β2-microglobulin levels, and copy number variations were determined using c-DNA, ELISA, and multiplex ligation-dependent probe amplification (MLPA), respectively. The scores were generated as per the weighted grades assigned to each variable involved in score categorization. The predictive value of prognostic models was assessed and compared using Harrell's C-index and Akaike's information criterion (AIC). Stratification of patients according to CLL-IPI yielded significant differences in terms of OS and TTFT (p < 0.001). Comparative assessment of scores for OS suggested better performance of CLL-IPI (C = 0.64, AIC = 740) followed by Barcelona-Brno (C = 0.61, AIC = 754) and MDACC score (C = 0.59, AIC = 759). Comparison of predictive value of prognostic scores for TTFT illustrated better performance of CLL-IPI (C = 0.72, AIC = 726) followed by Barcelona-Brno (C = 0.68, AIC = 743), modified GCLLSG (C = 0.66, AIC = 744), and O-CLL1 index (C = 0.55, AIC = 773). The results suggest better performance of CLL-IPI in terms of both OS and TTFT as compared to other available scores in our cohort.
    • Grant Information:
      BT/PR11106/GBD/27/145/2008 Department of Biotechnology , Ministry of Science and Technology; BT/PR15438/MED/30/606/2011 Department of Biotechnology , Ministry of Science and Technology; BT/PR8680/AGR/36/754/2013 Department of Biotechnology , Ministry of Science and Technology; 8-60/A060/ 2011/RS All-India Institute of Medical Sciences
    • Contributed Indexing:
      Keywords: CLL-IPI; Chronic lymphocytic leukemia in India; Prognostic index; Time to first treatment
    • Accession Number:
      0 (Immunoglobulin Heavy Chains)
      0 (beta 2-Microglobulin)
    • Publication Date:
      Date Created: 20181020 Date Completed: 20190128 Latest Revision: 20190128
    • Publication Date:
      20240829
    • Accession Number:
      10.1007/s00277-018-3525-0
    • Accession Number:
      30338367