Prognostic score and cytogenetic risk classification for chronic lymphocytic leukemia patients: Center for International Blood and Marrow Transplant Research report. Clinical cancer research : an official journal of the American Association for Cancer Research Kim, H. T., Ahn, K. W., Hu, Z. H., Davids, M. S., Volpe, V. n., Antin, J. H., Sorror, M. n., Shadman, M. n., Press, O. W., Pidala, J. n., Hogan, W. n., Negrin, R. n., Devine, S. n., Uberti, J. n., Agura, E. n., Nash, R. n., Mehta, J. n., McGuirk, J. P., Forman, S. n., Langston, A. n., Giralt, S. n., Perales, M. A., Battiwalla, M. n., Hale, G. n., Gale, R. P., Marks, D. I., Hamadani, M. n., Ganguly, S. n., Bacher, V. n., Lazarus, H. n., Reshef, R. n., Hildebrandt, G. C., Inamoto, Y. n., Cahn, J. Y., Solh, M. n., Kharfan-Dabaja, M. A., Ghosh, N. n., Saad, A. n., Aljurf, M. n., Schouten, H. C., Hill, B. T., Pawarode, A. n., Kindwall-Keller, T. n., Saba, N. S., Copelan, E. n., Nathan, S. n., Beitinjaneh, A. M., Savani, B. n., Cerny, J. n., Grunwald, M. R., Yared, J. n., Wirk, B. n., Nishihori, T. n., Chhabra, S. n., Olsson, R. n., Bashey, A. n., Gergis, U. n., Popat, U. n., Sobecks, R. M., Alyea, E. P., Saber, W. n., Brown, J. R. 2019

Abstract

To develop a prognostic model and cytogenetic risk classification for previously treated patients with chronic lymphocytic leukemia (CLL) undergoing reduced intensity conditioning (RIC) allogeneic hematopoietic cell transplantation (HCT).We performed a retrospective analysis of outcomes of 606 CLL patients who underwent RIC allogeneic HCT between 2008 and 2014 reported to the Center for International Blood and Marrow Transplant Research.Based on multivariable models, disease status, comorbidity index, lymphocyte count and white blood cell count at HCT were selected for the development of prognostic model. Using the prognostic score, we stratified patients into low, intermediate, high, and very high risk (4-year progression-free survival (PFS) 58%, 42%, 33%, and 25%, respectively, p<0.0001; 4-year overall survival (OS) 70%, 57%, 54%, and 38%, respectively, p<0.0001). We also evaluated karyotypic abnormalities together with del(17p) and found that del(17p) or =5 abnormalities showed inferior PFS. Using a multivariable model, we classified cytogenetic risk into low, intermediate, and high (p<0.0001). When the prognostic score and cytogenetic risk were combined, patients with low prognostic score and low cytogenetic risk had prolonged PFS (61% at 4-year) and OS (75% at 4-year).In this large cohort of previously treated CLL patients who underwent RIC HCT, we developed a robust prognostic scoring system of HCT outcomes and a novel cytogenetic based risk stratification system. These prognostic models can be used for counseling patients, comparing data across studies, and providing a benchmark for future interventions. For future study, we will further validate these models for patients receiving targeted therapies prior to HCT.

View details for DOI 10.1158/1078-0432.CCR-18-3988

View details for PubMedID 31253630