Hoechstetter, Manuela A., Busch, Raymonde, Eichhorst, Barbara, Buhler, Andreas, Winkler, Dirk, Bahlo, Jasmin, Robrecht, Sandra, Eckart, Michael J., Vehling-Kaiser, Ursula, Jacobs, Georg, Jaeger, Ulrich, Hurtz, Hans Juergen, Hopfinger, Georg, Hartmann, Frank, Fuss, Harald, Abenhardt, Wolfgang, Blau, Ilona, Freier, Werner, Mueller, Lothar, Goebeler, Maria, Wendtner, Clemens, Fischer, Kirsten, Herling, Carmen D., Starck, Michael, Bentz, Martin, Emmerich, Bertold, Doehner, Hartmut, Stilgenbauer, Stephan and Hallek, Michael (2020). Prognostic model for newly diagnosed CLL patients in Binet stage A: results of the multicenter, prospective CLL1 trial of the German CLL study group. Leukemia, 34 (4). S. 1038 - 1052. LONDON: NATURE PUBLISHING GROUP. ISSN 1476-5551

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Abstract

The heterogeneity of early stage CLL challenges prognostication, and refinement of prognostic indices for risk-adapted management in this population is essential. The aim of the multicenter, prospective CLL1 trial was to explore a novel prognostic model (CLL1-PM) developed to identify risk groups, separating patients with favorable from others with dismal prognosis. A cohort of 539 clinically, biochemically, and genetically characterized Binet stage A patients were observed until progression, first-line treatment, or death. Multivariate analysis identified six independent factors associated with overall survival (OS) and time-to-first treatment (TTFT): del(17p), unmutated IGHV, del(11q), ss2-microglobulin >3.5 mg/dL, lymphocyte doubling time (LDT) <12 months, and age >60 years. These factors were integrated into the CLL1-PM, which stratified patients into four risk groups. The CLL1-PM was prognostic for OS and TTFT, e.g., the risk of treatment at 5 years was 85.9, 51.8, 27.6, and 11.3% for very low (0-1.5), low (2-4), high (4.5-6.5), and very high-risk (7-14) scores, respectively (P < 0.001). Notably, in addition to factors comprising CLL-IPI, we substantiated del(11q) and LDT as prognostic factors in early CLL. Altogether, our findings would be useful to effectively stratify Binet stage A patients, particularly within the scope of clinical trials evaluating novel agents.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Hoechstetter, Manuela A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Busch, RaymondeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eichhorst, BarbaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Buhler, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Winkler, DirkUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bahlo, JasminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Robrecht, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eckart, Michael J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vehling-Kaiser, UrsulaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jacobs, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jaeger, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hurtz, Hans JuergenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hopfinger, GeorgUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hartmann, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuss, HaraldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Abenhardt, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blau, IlonaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Freier, WernerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, LotharUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goebeler, MariaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wendtner, ClemensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fischer, KirstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Herling, Carmen D.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Starck, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bentz, MartinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Emmerich, BertoldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doehner, HartmutUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Stilgenbauer, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hallek, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-345177
DOI: 10.1038/s41375-020-0727-y
Journal or Publication Title: Leukemia
Volume: 34
Number: 4
Page Range: S. 1038 - 1052
Date: 2020
Publisher: NATURE PUBLISHING GROUP
Place of Publication: LONDON
ISSN: 1476-5551
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
CHRONIC LYMPHOCYTIC-LEUKEMIA; SERUM THYMIDINE KINASE; PROGRESSION-FREE SURVIVAL; RECURRENT MUTATIONS; DOUBLING TIME; 1ST TREATMENT; INDEX; VALIDATION; RISK; DISEASEMultiple languages
Oncology; HematologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/34517

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