Authors: Stefano Molica Diana Giannarelli Luciano Levato Rosanna Mirabelli Massimo Gentile Mirella Lentini Fortunato Morabito
Publish Date: 2014/07/27
Volume: 100, Issue: 3, Pages: 290-295
Abstract
We propose an algorithm based on a slightly modified version of MD Anderson Cancer Center MDACC score ie mutational status of IgVH LDH presence of highrisk FISH abnormalities β2microglobulin and separation of clinical monoclonal Bcell lymphocytosis cMBL from chronic lymphocytic leukemia CLL to predict time to first treatment TTFT of a prospective multicentre cohort including 83 cMBL and 136 CLL Rai stage 0 patients Patients with MDACC score point ≥38 at any level of β2microglobulin and irrespective of whether they fulfilled 2008 International Workshop on CLL IWCLL criteria for CLL Rai stage 0 or cMBL experienced the worst clinical outcome 5year TTFT 24 and formed the highrisk group In contrast subjects with a diagnosis of cMBL MDACC score point 38 and β2microglobulin ≤ UNL had the best clinical outcome 5year TTFT 100 and constituted the lowrisk group The intermediate group included patients in Rai stage 0 MDACC score point 38 and any level of β2microglobulin and patients with cMBL MDACC score point 38 and β2microglobulin ≥ UNL Cases showing these features can be grouped together to form the intermediaterisk group 5year TTFT 65 Although the separation between cMBL and Rai stage 0 as proposed by the 2008 IWCLL guidelines has clinical implications the model we propose may help to classify patients with cMBL and Rai stage 0 into more precise subgroups suggesting that a prognostic separation of these entities based solely on clonal Bcell threshold may be unsatisfactory
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