Prognosis of Binet stage A chronic lymphocytic leukemia patients: the strength of routine parameters.
Recent developments in the management of chronic lymphocytic leukemia (CLL) patients have made necessary the availability of dependable prognostic factors. We have developed a prognostic index derived from the multivariate analysis of 339 stage A patients at diagnosis, exhaustively studied for classical and recent predictive markers. Only 4 biologic parameters were found to be independent predictors of progression-free survival (PFS): serum thymidine kinase (sTK), lymphocytosis, β2-microglobulin, and CD38 expression. Two groups were distinguishable: cases with no or 1 risk factor (among whom 85% did not progress after 7 years), and cases with 2 or more factors showing a median PFS of 20 months. Finally, we propose an easy, fast, cost-effective strategy for a trustworthy prognostication in stage A patients, who currently represent more than 80% of the CLL population, allowing physicians to adapt follow-up individually.
Letestu
Rémi
R
Université Paris13, Unité de Formation et de Recherche Santé-Médecine-Biologie Humaine (UFR SMBH), Bobigny, France.
Lévy
Vincent
V
Eclache
Virginie
V
Baran-Marszak
Fanny
F
Vaur
Dominique
D
Naguib
Dina
D
Schischmanoff
Olivier
O
Katsahian
Sandrine
S
Nguyen-Khac
Florence
F
Davi
Frédéric
F
Merle-Béral
Hélène
H
Troussard
Xavier
X
Ajchenbaum-Cymbalista
Florence
F
D018572:Disease-Free Survival; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis*; D015999:Multivariate Analysis; D011379:Prognosis