CLL–International Prognostic Index in Predicting Cause of Death in Newly Diagnosed CLL
Posted: Monday, October 11, 2021
Chronic lymphocytic leukemia (CLL)–International Prognostic Index (CLL-IPI) risk scores appear to play a crucial role in predicting the cause of death in newly diagnosed CLL, based on correspondence published in the Blood Cancer Journal. Sameer A. Parikh, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues conducted an analysis to determine whether the cause of death among patients with newly diagnosed CLL correlated with their CLL-IPI risk group. This analysis focused on 1,274 patients from the Mayo Clinic database who were evaluated within 1 year of a CLL diagnosis.
Low-risk disease (35.2%) was the most common diagnosis, followed by intermediate-risk (34.7%), high-risk (24.9%), and very-high–risk (5.3%) disease. At a median follow-up of 5 years, a total of 574 patients received treatment for CLL. The overall survival rates at 5 and 10 years were 85% and 64%, respectively, with a median overall survival of 17 years. Causes of death included CLL progression (n = 99), unknown (n = 65), causes unrelated to CLL (n = 59), second malignancy (n = 47), and infection (n = 16).
The cumulative incidence of death at 5 and 10 years for CLL progression, CLL-related complications, and CLL-unrelated death was 5.7% and 13.2%, 3.2% and 8.5%, and 3.8% and 8.7%, respectively. Among patients with low-risk disease, the cumulative incidence of death rates was similar for all causes at 5 (0.3% vs. 2.1% vs. 0.6%) and 10 (2.8% vs. 6.4% vs. 3.6%) years; individuals with intermediate-risk disease also exhibited similar rates regarding all causes of death at 5 (2.0% vs. 2.5% vs. 3.1%) and 10 (10.4% vs. 7.0% vs. 7.4%) years. In contrast, patients with high-risk or very-high–risk disease had a higher risk of CLL progression than related complications or unrelated causes by nearly threefold at both time points (17.3% vs. 5.7% vs. 8.6% and 30.3% vs. 12.9% vs. 16.9%).
Disclosure: For full disclosures of the study authors, visit nature.com.