Morabito et al evaluated patients with chronic lymphocytic leukemia (CLL) using serum light chain concentrations. The authors are from multiple institutions in Italy.
Patient selection: CLL, not treated
Parameters:
(1) ZAP70 expression in flow cytometry
(2) FISH abnormalities (high risk 11q22.3, 17p13.1; intermediate risk trisomy 12)
(3) Binet stage
(4) total concentration of kappa and lambda light chains in the serum
Parameter
Finding
Points
ZAP70 expression
negative
0
positive
1
FISH abnormalities
absent
present
Binet Stage
A
B or C
total light chains
< 60.6 mg/L
>= 60.6 mg/L
where:
• On page 5356 a cutoff of 60.6 mg/mL is given. This would be 6 g/dL. On page 6354 units for light chains are mg/L.
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the more likely that the patient will require therapy.
Total Score
Risk Group
Proportion Not Treated at 10 Years
low
78%
intermediate
34%
2, 3 or 4
high
0%
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Specialty: Hematology Oncology
