Pflug et al reported a prognostic index for patients with chronic lymphocytic leukemia. This can help to identify a patient with CLL who may benefit from more aggressive management. The authors are from the German CLL Study Group and the Mayo Clinic.
Patient selection: newly diagnosed CLL
Parameters:
(1) cytogenetic findings from the hierarchical model
(2) serum thymidine kinase in U/L
(3) serum beta-2 microglobulin in mg/L
(4) IGHV (gene encoding the Ig heavy chain V-III region VH26)
(5) ECOG performance status (from 0 to 4)
(6) gender
(7) age in years
Parameter |
Finding |
Points |
cytogenetic findings |
del(17p) |
6 |
|
del(11q) |
1 |
|
other |
0 |
serum thymidine kinase |
<= 10 U/L |
0 |
|
> 10 U/L |
2 |
serum beta-2 microglobulin |
<= 1.70 mg/L |
0 |
|
1.71 to 3.5 mg/L |
1 |
|
> 3.5 mg/L |
2 |
IGHV |
not mutated |
1 |
|
mutated |
0 |
ECOG performance status |
0 |
0 |
|
1 to 4 |
1 |
gender |
female |
0 |
|
male |
1 |
age |
<= 60 years |
0 |
|
> 60 years |
1 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• The higher the score the greater the risk.
Total Score |
Risk Group |
5-Year Overall Survival |
0 to 2 |
low |
95% |
3 to 5 |
intermediate |
90% |
6 to 10 |
high |
70% |
11 to 14 |
very high |
14-19% |
Specialty: Hematology Oncology