Servicio de Hematología, Hospital Universitario Infanta Leonor, Madrid, Spain.
Departamento de Medicina, Universidad Complutense de Madrid, Madrid, Spain.
Biomed Res Int. 2018 Mar 15;2018:9506979. doi: 10.1155/2018/9506979. eCollection 2018.
In recent years, new prognostic indexes (PIs) for chronic lymphocytic leukemia (CLL), which include clinical, biological, and genetic variables, have been validated, highlighting the MD Anderson Cancer Center prognostic index (MDACC PI), the CLL-international prognostic index (CLL-IPI), and the Barcelona-Brno biomarkers only prognostic model. The aim of this study is to compare the utility of these PIs in a cohort of Spanish patients. A retrospective analysis of 696 unselected CLL patients newly diagnosed and previously untreated from different Spanish institutions was performed. The MDACC PI, the CLL-IPI, and the biomarkers only PI were applied to these patients, and a comparison of the three PIs was performed. With a median follow-up time of 46 months, 394 patients were alive and 187 had received treatment. The median overall survival (OS) was 173 months and the median time to first therapy (TTFT) was 32 months. Significant differences were obtained in OS and TTFT for all subgroups when applying these PIs, with the CLL-IPI being the one with the higher -index (0.676 for OS and 0.757 for TTFT). The three PIs were able to discriminate patients in different prognostic subgroups. In our cohort, the CLL-IPI showed higher power in predicting TTFT and OS.
近年来,新的慢性淋巴细胞白血病(CLL)预后指标(PI)已经得到验证,这些指标包括临床、生物学和遗传学变量,突出了 MD 安德森癌症中心预后指数(MDACC PI)、CLL 国际预后指数(CLL-IPI)和巴塞罗那-布尔诺生物标志物唯一预后模型。本研究旨在比较这些指标在西班牙患者队列中的应用。对来自不同西班牙机构的 696 例未经选择的新诊断和未经治疗的 CLL 患者进行了回顾性分析。对这些患者应用了 MDACC PI、CLL-IPI 和仅生物标志物 PI,并对这三种 PI 进行了比较。中位随访时间为 46 个月,394 例患者存活,187 例患者接受了治疗。中位总生存期(OS)为 173 个月,首次治疗时间(TTFT)为 32 个月。当应用这些 PI 时,所有亚组的 OS 和 TTFT 均有显著差异,其中 CLL-IPI 的指数最高(OS 为 0.676,TTFT 为 0.757)。这三种 PI 能够区分不同预后亚组的患者。在我们的队列中,CLL-IPI 在预测 TTFT 和 OS 方面显示出更高的效能。