Evaluation of the CLL-IPI in relapsed and refractory chronic lymphocytic leukemia in idelalisib phase-3 trials. Academic Article uri icon

Overview

abstract

  • The CLL-IPI is a risk-weighted prognostic model for previously untreated patients with chronic lymphocytic leukemia (CLL), but has not been evaluated in patients with relapsed CLL or on novel therapies. We evaluated the CLL-IPI in 897 patients with relapsed/refractory CLL in 3 randomized trials testing idelalisib (PI3Kδ inhibitor). The CLL-IPI identified patients as low (2.2%), intermediate (12.8%), high (48.7%), and very high (36.2%) risk and was prognostic for survival (log-rank p < .0001; C-statistic 0.706). Of CLL-IPI factors, age >65, β2-microglobulin >3.5mg/L, unmutated immunoglobulin heavy chain variable region gene, and deletion 17p/TP53 mutation were independently prognostic, but Rai I-IV or Binet B/C was not. The CLL-IPI is prognostic for survival in relapsed CLL and with idelalisib therapy. However, low/intermediate risk is uncommon, and regression parameters of individual factors in this risk-weighted model appear different in relapsed CLL. Reassessment of the weighting of the individual variables might optimize the model in this setting.

publication date

  • November 8, 2018

Research

keywords

  • Antineoplastic Combined Chemotherapy Protocols
  • Leukemia, Lymphocytic, Chronic, B-Cell
  • Models, Biological
  • Neoplasm Recurrence, Local
  • Purines
  • Quinazolinones

Identity

PubMed Central ID

  • PMC6545166

Scopus Document Identifier

  • 85057523847

Digital Object Identifier (DOI)

  • 10.1080/10428194.2018.1540782

PubMed ID

  • 30407886

Additional Document Info

volume

  • 60

issue

  • 6