Ahn et al reported a prognostic model for patients with chronic lymphocytic leukemia (CLL) treated with ibrutinib. The authors are from National Heart, Lung and Blood Institute, Pharmacyclics LLC, Neogenomics Laboratories and Genomic Testing Cooperative (Irvine).
Patient selection: chronic lymphocytic leukemia treated with ibrutinib
Parameters:
(1) history of prior treatment (relapse or refractory)
(2) TP53 aberration
(3) serum beta-2 microglobulin in mg/L
(4) serum LDH in IU/L
Parameter
Finding
Points
history of prior treatment
no
0
yes
1
aberration in TP53
no
0
yes
1
serum beta-2 microglobulin
< 5 mg/L
0
>= 5 mg/L
1
serum LDH
<= 250 IU/L
0
> 250 IU/L
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
Total Score
Risk Group
3-Year Overall Survival
0 or 1
low
93%
2
intermediate
83%
3 or 4
high
63%
The high risk group was more likely to show:
(1) Richter transformation
(2) BTK mutation (associated with ibrutinib resistance)
(3) PLCG2 mutation(associated with ibrutinib resistance
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