Tam et al evaluated patients with chronic lymphocytic leukemia showing a de novo deletion of 17p13.1. They identified factors that can help to identify patients with more aggressive disease. The authors are from the University of Texas M.D. Anderson Cancer Center, St. Vincent's Hospital in Melbourne, and Mayo Clinic in Rochester.
Patient selection: CLL with de novo deletion 17p13.1
Parameters:
(1) Rai Stage (from 0 to 4)
(2) immunoglobulin variable region heavy chain (IgVH)
(3) percent of nuclei positive for the deletion by FISH
Parameter
Finding
Points
Rai Stage
0
0
1 or higher
1
IgVH
mutated
0
unmutated
1
percent nuclei positive for deletion
< 25%
0
>= 25%
1
number of risk factors for progressive disease =
= SUM(points for Rai stage and IgVH)
number of factors affecting overall survival =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors for both: 0
• maximum number of risk factors for progressive disease: 2
• maximum number of factors affecting overall survival: 3
Number of Factors for Overall Survival
Risk Group
3-Year Survival
0 or 1
low
95%
2
moderate
74%
3
high
22%
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