Science Journal of Clinical Medicine

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Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience

Received: 16 November 2014    Accepted: 24 November 2014    Published: 27 November 2014
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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.

DOI 10.11648/j.sjcm.20140306.15
Published in Science Journal of Clinical Medicine (Volume 3, Issue 6, November 2014)
Page(s) 124-128
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

CLL, Prognostic Index, Nomogram, Prognosis

References
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Author Information
  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

  • University Clinic for Haematology, Medical Faculty, University St. Cyril and Methodius, Skopje - R. Macedonia

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    Trajkova Sanja, Cevreska Lidija, Ivanovski Martin, Dukovski Dusko, Simjanovska-Popova Marija, et al. (2014). 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, 3(6), 124-128. https://doi.org/10.11648/j.sjcm.20140306.15

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    ACS Style

    Trajkova Sanja; Cevreska Lidija; Ivanovski Martin; Dukovski Dusko; Simjanovska-Popova Marija, et al. Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience. Sci. J. Clin. Med. 2014, 3(6), 124-128. doi: 10.11648/j.sjcm.20140306.15

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    AMA Style

    Trajkova Sanja, Cevreska Lidija, Ivanovski Martin, Dukovski Dusko, Simjanovska-Popova Marija, et al. Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience. Sci J Clin Med. 2014;3(6):124-128. doi: 10.11648/j.sjcm.20140306.15

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  • @article{10.11648/j.sjcm.20140306.15,
      author = {Trajkova Sanja and Cevreska Lidija and Ivanovski Martin and Dukovski Dusko and Simjanovska-Popova Marija and Stankovik Svetlana and Panovska-Stavridis Irina},
      title = {Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience},
      journal = {Science Journal of Clinical Medicine},
      volume = {3},
      number = {6},
      pages = {124-128},
      doi = {10.11648/j.sjcm.20140306.15},
      url = {https://doi.org/10.11648/j.sjcm.20140306.15},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.sjcm.20140306.15},
      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. 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.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Evaluation of Reproducibility of Prognostic Index and Nomogram in Prognosis, and Therapeutically Approach of Patients with Chronic Lymphocytic Leukaemia-Single Centre Experience
    AU  - Trajkova Sanja
    AU  - Cevreska Lidija
    AU  - Ivanovski Martin
    AU  - Dukovski Dusko
    AU  - Simjanovska-Popova Marija
    AU  - Stankovik Svetlana
    AU  - Panovska-Stavridis Irina
    Y1  - 2014/11/27
    PY  - 2014
    N1  - https://doi.org/10.11648/j.sjcm.20140306.15
    DO  - 10.11648/j.sjcm.20140306.15
    T2  - Science Journal of Clinical Medicine
    JF  - Science Journal of Clinical Medicine
    JO  - Science Journal of Clinical Medicine
    SP  - 124
    EP  - 128
    PB  - Science Publishing Group
    SN  - 2327-2732
    UR  - https://doi.org/10.11648/j.sjcm.20140306.15
    AB  - 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. 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.
    VL  - 3
    IS  - 6
    ER  - 

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