Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience
Science Journal of Clinical Medicine
Volume 3, Issue 6, November 2014, Pages: 124-128
Received: Nov. 16, 2014; Accepted: Nov. 24, 2014; Published: Nov. 27, 2014
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Authors
Trajkova Sanja, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
Cevreska Lidija, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
Ivanovski Martin, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
Dukovski Dusko, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
Simjanovska-Popova Marija, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
Stankovik Svetlana, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
Panovska-Stavridis Irina, University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia
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Abstract
At this time staging and prognostication of Chronic lymphocytic leukemia( CLL) is performed by 2 equivalent clinical staging systems developed 30 to 35 years ago by Binet and Rai Both systems use low-cost, simple components such as blood counts and physical examination to identify 3 major prognostic subgroups. Despite these advantages, the clinical staging systems do not reflect the high unpredictability of CLL, nor do they account for known biological characteristics of CLL cells predicting survival and response to therapy. That was the motivation for Mayo Clinic, and Wierda proposed to combine a set of clinical risk factors, to develop a prognostic index (PI) stratifying patients in three risk groups with different expected median survival, and a nomogram, estimating individual patient survivals. Here we report the results from a study designed to evaluate Wierda`s nomogram and prognostic index on Macedonian CLL population. Material and methods: We analyzed medical data of 300 CLL patients diagnosed and treated at University Clinic of Hematology -Skopje Macedonia from a period of 10 years. We used Wierda`s prognostics index and a nomogram, to see 5- and 10-year survival probability and estimated median survival time. Results: There were 300 CLL patients who had traditional and biological prognostic factors evaluated. According to prognostic index a classification tree was built that identified three subsets of patients. Estimated median survival at low risk subset of patients with prognostic nomogram <80 was 68, 7 months, and 37, 5 months respectively at high risk subsets of patients with prognostic nomogram >80. Projected survival in respectively low, intermediate and high-risk groups was 91, 7%, 80%, 50%, and 81, 5%, 60%, 10% at 5-year and10-year, respectively. Conclusion: We use this model to identify patients at high risk for progression to treatment and we are experiencing a paradigm shift toward personalized medicine. This prognostic model may help patients and clinicians in clinical decision making as well as in clinical research and clinical trial design.
Keywords
CLL, Prognostic Index, Nomogram, Prognosis
To cite this article
Trajkova Sanja, Cevreska Lidija, Ivanovski Martin, Dukovski Dusko, Simjanovska-Popova Marija, Stankovik Svetlana, Panovska-Stavridis Irina, Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience, Science Journal of Clinical Medicine. Vol. 3, No. 6, 2014, pp. 124-128. doi: 10.11648/j.sjcm.20140306.15
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