A clinical staging system for chronic lymphocytic leukemia.Prognostic significance

Abstract

One hundred and twenty-nine patients with chronic lymphocytic leukemia (CLL) followed in our outpatient department for periods ranging from 6 months to 13 years were divided into five anatomico-clinical stages: stage 0 (peripheral and bone marrow lymphocytosis); stage I (stage 0 + lymph node enlargement); stage I1 (stage 0 + palpable spleen); stage 111 (stage I + 11); and stage IV (anemia or thrombocytopenia) . Analysis of actuarial survival curves revealed the following: 1) median survival of the entire population exceeded 114 months; 2) there was no difference between the curves of stage 0 and stage I patients, 3) there was a significant difference between survival for stage 111 and IV patients as compared with stages 0, I and I1 (p < 0.01); and 4) median survival for stage I11 and stage IV was 70 months; and 23 months, respectively. Age did not appear to be a prognostic factor. Prognosis was poorer in male patients and in those with a high initial lymphocyte count (50,000/mma), but this was due to the higher incidence of stages 111 and IV in this population ( p <

Serum metabolome analysis by 1H-NMR reveals differences between chronic lymphocytic leukaemia molecular subgroups

“…3 The remaining one-third are characterised by an initial indolent phase followed by disease progression. Disease staging systems developed by Rai 4 and Binet, 5 which enable classification of patients into good, intermediate and poor prognostic outcome groups have facilitated the determination of treatment course. However, neither provide the means for early stage diagnosis nor the discrimination of stable and progressive forms of CLL.…”

The role of prognostic factors in assessing ‘high-risk’ subgroups of patients with chronic lymphocytic leukemia

“…This was largely due to the previous lack of effective therapies that could induce complete remission and due to the older age of patients (median 65-70 years at diagnosis) 3 with CLL; thus, patients were often thought to die of causes unrelated to their disease. Both the Binet and Rai 4,5 staging systems for CLL have traditionally been used to stratify patients into prognostic groups based on assessments of disease burden. Although the staging systems play a critical role in determining the natural course of the disease and the need for therapy, they do not predict for the likelihood of disease progression among patients with early-stage (Rai stage 0 or Binet stage A) disease.…”

High expression of activation-induced cytidine deaminase (AID) mRNA is associated with unmutated IGVH gene status and unfavourable cytogenetic aberrations in patients with chronic lymphocytic leukaemia

“…[1][2][3][4] Unfortunately, theses systems are unable to predict disease progression in early stages (Binet A, Rai 0-II) or resistance to chemotherapy. Subsequently, novel prognostic factors have been defined: lymphocyte doubling time (LDT), pattern of bone marrow infiltration, LDH, serum b2-microglobulin, soluble CD23, serum thymidine kinase, expression of CD38, cytogenetic aberrations and mutational status of immunoglobulin heavy chain variable region genes (IGV H ).…”