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Reassessing the chronic lymphocytic leukemia International Prognostic Index in the era of targeted therapies.
Langerbeins, Petra; Giza, Adam; Robrecht, Sandra; Cramer, Paula; von Tresckow, Julia; Al-Sawaf, Othman; Fink, Anna Maria; Fürstenau, Moritz; Kutsch, Nadine; Simon, Florian; Goede, Valentin; Hoechstetter, Manuela; Niemann, Carsten Utoft; da Cunha-Bang, Caspar; Kater, Arnon; Dubois, Julie; Gregor, Michael; Staber, Philipp Bernhard; Tausch, Eugen; Schneider, Christof; Stilgenbauer, Stephan; Eichhorst, Barbara; Fischer, Kirsten; Hallek, Michael.
Afiliación
  • Langerbeins P; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Giza A; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Robrecht S; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Cramer P; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • von Tresckow J; Department of Hematology and Stem Cell Transplantation, West German Cancer Center, University of Duisburg-Essen, Essen, Germany.
  • Al-Sawaf O; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Fink AM; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Fürstenau M; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Kutsch N; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Simon F; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Goede V; Division of Oncogeriatrics, St. Marien Hospital, Cologne, Germany.
  • Hoechstetter M; Interdisciplinary Oncology Center Munich, Outpatient Clinic, Day Hospital, Center for Clinical Trials, Hematology and Oncology, Munich, Germany.
  • Niemann CU; Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
  • da Cunha-Bang C; Department of Hematology, Rigshospitalet, Copenhagen, Denmark.
  • Kater A; Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
  • Dubois J; Department of Hematology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands.
  • Gregor M; Division of Hematology, Luzerner Kantonspital, Lucerne, Switzerland.
  • Staber PB; Division of Hematology and Hemostaseology, Medicine I, Medical University of Vienna, Vienna, Austria.
  • Tausch E; Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of Vienna, Department of Internal Medicine I, Vienna, Austria.
  • Schneider C; Department of Internal Medicine III, Division of CLL, University Hospital Ulm, Ulm, Germany.
  • Stilgenbauer S; Department of Internal Medicine III, Division of CLL, University Hospital Ulm, Ulm, Germany.
  • Eichhorst B; Department of Internal Medicine III, Division of CLL, University Hospital Ulm, Ulm, Germany.
  • Fischer K; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
  • Hallek M; Department I of Internal Medicine and German CLL Study Group, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany.
Blood ; 143(25): 2588-2598, 2024 06 20.
Article en En | MEDLINE | ID: mdl-38620092
ABSTRACT
ABSTRACT We evaluated the chronic lymphocytic leukemia International Prognostic Index (CLL-IPI) in patients with CLL treated first line with targeted drugs (n = 991) or chemoimmunotherapy (n = 1256). With a median observation time of 40.5 months, the 3-year progression-free survival (PFS) rates for targeted drug-treated patients varied by CLL-IPI risk group 96.5% (low), 87.6% (intermediate), 82.4% (high), and 78.7% (very high). Differences between consecutive CLL-IPI risk groups were observed for intermediate vs low and high vs intermediate, but not very high vs high. CLL-IPI factors ß2-microglobulin, immunoglobulin heavy variable (IGHV) status, and TP53 status each retained prognostic value for PFS. The 3-year overall survival (OS) rates by CLL-IPI risk groups were 100%, 96%, 93.9%, and 89.4%, respectively, with no differences between consecutive risk groups. Age, Binet stage, ß2-microglobulin, and TP53 status each retained prognostic value for OS. In chemoimmunotherapy patients (median observation time, 66.9 months), 3-year PFS rates for CLL-IPI risk groups were 78.1%, 51.4%, 40.1%, and 16.5%, respectively; corresponding 3-year OS rates were 97.4%, 93.1%, 81.8%, and 57.3%. In a matched-pair analysis, PFS differences in targeted therapies (n = 812) vs chemoimmunotherapy (n = 812) across all risk groups and OS differences in all but patients at low risk were demonstrated. The CLL-IPI maintains its prognostic value in predicting PFS outcomes with targeted drugs, but its impact in predicting survival appears diminished. Targeted therapies showed enhanced outcomes over chemoimmunotherapy, highlighting their effectiveness across various risk groups. Our findings support ongoing assessment of prognostic tools in CLL treatment evolution. These trials were registered at www.ClinicalTrials.gov as #NCT02345863, #NCT02401503, #NCT02689141, #NCT02445131, #NCT02758665, #NCT02950051, #NCT02242942, #NCT00262782, #NCT00281918, and #NCT01010061.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Terapia Molecular Dirigida Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Blood Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Leucemia Linfocítica Crónica de Células B / Terapia Molecular Dirigida Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Revista: Blood Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos