Cohen et al reported a laboratory score for identifying a patient with early stage chronic lymphocytic leukemia (CLL) who may require early treatment. The authors are from multiple institutions in Europe and the United States.
Patient selection: CLL Rai 0, Binet A
Outcome: time to first treatment (TTFT)
Parameters:
(1) 17p- (FISH threshhold 10%)
(2) IGHV
(3) 11q- (FISH threshhold 5%)
(4) +12 (trisomy 12, FISH threshhold 5%)
(5) WBC count per µL
Parameter
Finding
Points
17p-
absent
0
present
2
IGHV
mutated
0
unmutated
2
11q-
absent
0
present
1
+12
absent
0
present
1
WBC count
<= 32,000 per µL
0
> 32,000 per µL
1
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the risk of early treatment (shorter TTFT).
Score
Risk
Median TTFT (Mayo Cohort)
0
low
127 months
1-2
intermediate
76 months
>= 3
high
36 months
Performance:
• The area under the ROC curve was around 0.75.
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