Role of Prognostic Nomogram and Survival Index in Prognosis and the Outcome of Patients with Chronic Lymphocytic Leukemia - A Single Center Experience
Journal
Internal Medicine: Open Access
Date Issued
2018
Author(s)
Cevreska L
Ivanovski M
Popova-Labachevska M
DOI
10.4172/2165-8048.1000283
Abstract
Introduction: Chronic lymphocytic leukemia (CLL) in its clinical course is a heterogeneous clonal
lymphoproliferative disease. Some patients live without the need for therapy for decades, while in others the clinical
course is aggressive. Research focuses on the identification of biological factors that affect this heterogeneity.
Clinical systems for division by stages Rai and Binet cannot identify whether the patient will have an indolent or
progressive course of the disease. At Texas University, "MD Anderson Cancer Center" with statistical analysis,
several independent features have been identified that predict the overall survival and a model composed of
several independent parameters with which patients are divided into 3 risk groups has been created. A nomogramprognostic model has been created that estimates the mean survival and predicts a probable total of five and ten
years of survival using the six variables.
Aim of the study: Evaluation of the applicability of the prognostic index and nomogram in terms of overall
survival, prognosis in patients with CLL diagnosed and treated at the University's clinic for hematology in a period
of ten years.
Material and methods: The study is set up retrospectively and includes 300 patients with CLL diagnosed and
treated at the University Clinic of Hematology for a period of 10 years. The CLL diagnosis was made according to
the recommendations of the CLL International Working Group (IWCLL). Clinical stratification was done as part of the
prognostic index, and the nomogram was implemented according to the RAI system. With the help of the prognostic
index, patients were stratified into three prognostic risk groups (low, intermediate, high risk), and according to the
prognostic nomogram, the median survival and the probable five and ten years total survival were assessed.
Results: The multivariate Cox Proportional model has confirmed ECOG and ALC that they affect the overall
survival time. The estimated mean-median probability of 5-year survival according to the prognostic nomogram in
patients with CLL is 77.5%, and the estimated Probability for 10-year survival according to the prognosis nomogram
is 50.0%.
Conclusion: The evaluation determined that the prognostic index and nomogram are reproducible in patients
with CLL diagnosed and treated in R. Macedonia. Characteristics that predict total survival and survival without
therapy have been identified.
lymphoproliferative disease. Some patients live without the need for therapy for decades, while in others the clinical
course is aggressive. Research focuses on the identification of biological factors that affect this heterogeneity.
Clinical systems for division by stages Rai and Binet cannot identify whether the patient will have an indolent or
progressive course of the disease. At Texas University, "MD Anderson Cancer Center" with statistical analysis,
several independent features have been identified that predict the overall survival and a model composed of
several independent parameters with which patients are divided into 3 risk groups has been created. A nomogramprognostic model has been created that estimates the mean survival and predicts a probable total of five and ten
years of survival using the six variables.
Aim of the study: Evaluation of the applicability of the prognostic index and nomogram in terms of overall
survival, prognosis in patients with CLL diagnosed and treated at the University's clinic for hematology in a period
of ten years.
Material and methods: The study is set up retrospectively and includes 300 patients with CLL diagnosed and
treated at the University Clinic of Hematology for a period of 10 years. The CLL diagnosis was made according to
the recommendations of the CLL International Working Group (IWCLL). Clinical stratification was done as part of the
prognostic index, and the nomogram was implemented according to the RAI system. With the help of the prognostic
index, patients were stratified into three prognostic risk groups (low, intermediate, high risk), and according to the
prognostic nomogram, the median survival and the probable five and ten years total survival were assessed.
Results: The multivariate Cox Proportional model has confirmed ECOG and ALC that they affect the overall
survival time. The estimated mean-median probability of 5-year survival according to the prognostic nomogram in
patients with CLL is 77.5%, and the estimated Probability for 10-year survival according to the prognosis nomogram
is 50.0%.
Conclusion: The evaluation determined that the prognostic index and nomogram are reproducible in patients
with CLL diagnosed and treated in R. Macedonia. Characteristics that predict total survival and survival without
therapy have been identified.
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