title: Evaluation of clinical staging in chronic lymphocytic leukemia- population-based study.
abstract: The Rai and Binet staging systems are currently being challenged by the development of new biological methods to characterize the prognosis and management of chronic lymphocytic leukemia (CLL). To evaluate these two systems in recently diagnosed CLL patients, we performed a retrospective population-based study including 344 patients in western Sweden diagnosed between 1995 and 2000. Binet stage A patients had longer median overall survival (OS) (100 months) than stage B (55 months; P < 0.001) and C patients (45 months; P < 0.0005). Median OS for stage B and C could not be separated (P = 0.94). When transferring Rai stages into three groups, a similar pattern was found. Overall response differed only between Binet A and C patients and there was no difference regarding time to next treatment between any of the Binet stages. Finally, in both systems, low stage patients had inferior survival compared to age- and sex-matched controls. Our data emphasize the need for a new risk stratification system for CLL patients.
authors.affiliation: Section of Haematology and Coagulation, Department of Internal Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Apelgren
authors.forename: Sverker
authors.initials: S
authors.lastname: Hasselblom
authors.forename: Olle
authors.initials: O
authors.lastname: Werlenius
authors.forename: Herman
authors.initials: H
authors.lastname: Nilsson-Ehle
authors.forename: Per-Ola
authors.initials: PO
authors.lastname: Andersson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome