Universität zu Köln

Brieghel, Christian ORCID: 0000-0002-1816-8106, Galle, Veerle, Agius, Rudi, Da Cunha-Bang, Caspar, Andersen, Michael A., Vlummens, Philip ORCID: 0000-0001-8275-2887, Mattsson, Mattias ORCID: 0000-0002-9510-8801, Rosenquist, Richard ORCID: 0000-0002-0211-8788, Smedby, Karin E., Herling, Carmen D., Bahlo, Jasmin, Hallek, Michael ORCID: 0000-0002-7425-4455, Lundgren, Jens D., Offner, Fritz and Niemann, Carsten U. (2022). Identifying patients with chronic lymphocytic leukemia without need of treatment: End of endless watch and wait? Eur. J. Haematol., 108 (5). S. 369 - 379. HOBOKEN: WILEY. ISSN 1600-0609

Full text not available from this repository.

Abstract

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.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Brieghel, Christian UNSPECIFIED orcid.org/0000-0002-1816-8106 UNSPECIFIED Galle, Veerle UNSPECIFIED UNSPECIFIED UNSPECIFIED Agius, Rudi UNSPECIFIED UNSPECIFIED UNSPECIFIED Da Cunha-Bang, Caspar UNSPECIFIED UNSPECIFIED UNSPECIFIED Andersen, Michael A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vlummens, Philip UNSPECIFIED orcid.org/0000-0001-8275-2887 UNSPECIFIED Mattsson, Mattias UNSPECIFIED orcid.org/0000-0002-9510-8801 UNSPECIFIED Rosenquist, Richard UNSPECIFIED orcid.org/0000-0002-0211-8788 UNSPECIFIED Smedby, Karin E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Herling, Carmen D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bahlo, Jasmin UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED orcid.org/0000-0002-7425-4455 UNSPECIFIED Lundgren, Jens D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Offner, Fritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemann, Carsten U. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-690836
DOI:	10.1111/ejh.13743
Journal or Publication Title:	Eur. J. Haematol.
Volume:	108
Number:	5
Page Range:	S. 369 - 379
Date:	2022
Publisher:	WILEY
Place of Publication:	HOBOKEN
ISSN:	1600-0609
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language B-CELL LYMPHOCYTOSIS; PROGNOSTIC INDEX; CLL-IPI; INFECTIONS; SURVIVAL; RISK Multiple languages Hematology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69083