Molica et al reported a simple score for evaluating a patient with chronic lymphocytic leukemia (CLL) in relapse. This can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Italy.
Patient selection: chronic lymphocytic leukemia (CLL), in relapse
Features of high risk:
(1) 11q deletion
(2) TP53 mutations
(3) unmutated immunoglobulin heavy chain (IGHV) gene
Parameters:
(1) serum LDH
(2) Rai stage
(3) time from the start of last therapy (early progression)
Parameter
Finding
Points
serum LDH
<= 250 U/L
0
> 250 U/L
1
Rai stage
I or II
0
III or IV
1
time from start of therapy
< 24 months
1
>= 24 months
0
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
Total Score
Risk Group
5-Year Overall Survival
0
low
91%
1
intermediate
83%
2 or 3
high
46%
Performance:
• The area under the ROC curve ranged from 0.66 to 0.69.
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