The International CLL-IPI Working Group developed 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 an international group of hematologists.
Patient selection: newly diagnosed CLL
Parameters:
(1) TP53 or del(17p) status
(2) IGHV (gene encoding the Ig heavy chain V-III region VH26)
(3) serum beta-2 microglobulin in mg/L
(4) clinical stage (Binet or Rai)
(5) age in years
Parameter |
Finding |
Points |
TP53 or del(17p)status |
neither mutation |
0 |
|
TP53 mutated and/or del(17p) |
4 |
IGHV |
not mutated |
2 |
|
mutated |
0 |
serum beta-2 microglobulin |
<= 3.5 mg/L |
0 |
|
> 3.5 mg/L |
2 |
clinical stage |
Binet A or Rai 0 |
0 |
|
other |
1 |
Age |
<= 65 years |
0 |
|
> 65 years |
1 |
where:
• Clinical stage “other is Binet B or C, Rai I to IV.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk.
Total Score |
Risk Group |
10-Year Overall Survival |
0 or 1 |
low |
79-87%% |
2 or 3 |
intermediate |
36-55%% |
4 to 6 |
high |
16-23% |
7 to 10 |
very high |
0-7%% |
Specialty: Hematology Oncology