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Chronic lymphocytic leukemia

Survival risk score for real-life relapsed/refractory chronic lymphocytic leukemia patients receiving ibrutinib. A campus CLL study

Leukemia volume 35, pages 235–238 (2021)Cite this article

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Nowadays, the identification of prognostic models for overall survival (OS) prediction specifically applicable in relapsed/refractory chronic lymphocytic leukemia (R/R CLL) in treatment with the novel target drugs may represent an important goal of clinical research on CLL. Recently, a retrospective pooled cohort study based on an international collaboration collected information from ~2500 R/R CLL patients treated either with chemo-immunotherapy or new drugs (ibrutinib, idelalisib, or venetoclax) and proposed a comprehensive risk score for the OS prediction, based on four widely accessible parameters (i.e., β2-microglobulin, anemia, LDH, last therapy, a.k.a. BALL score) [1]. Although this score may represent an easy “globally applicable” model to be used in the daily clinical practice in order to improve risk stratification in all R/R CLL patients, its validation in the setting of ibrutinib, which in the clinical practice represents the most used drug in R/R patients, is still lacking.

In the present study, from an institutional Italian multicenter working group on CLL (“Campus CLL”), we developed a weighted, multivariate score [survival risk score for ibrutinib (SRSI)] for OS prediction by integrating clinical, laboratory, and biological parameters, as evaluated at the time of ibrutinib initiation in an independent cohort of R/R CLL patients who received ibrutinib 420 mg/day outside of clinical trials as salvage therapy and compared this new score with the BALL score in our cohort (Supplementary Table 1).

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Fig. 1: Overall survival.

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Funding

Associazione Italiana Ricerca Cancro (AIRC), Milan Italy Investigator Grant IG-21687 (to VG), Progetto Ricerca Finalizzata PE 2016-02362756, Ministero della Salute, Rome, Italy (to VG); AIRC Grant 5x1000 no. 9980 (to FM); AIRC and Fondazione CaRiCal co-financed Multi-Unit Regional Grant 2014 no. 16695 (to FM); AIRC 5x1000, Metastases Special Program no. 21198, Milan, Italy (to GG); RF-2011-02349712, MoH, Rome, Italy (to GG); PRIN 2015ZMRFEA_004, MIUR, Rome, Italy (to GG); and AGING Project—Department of Excellence—DIMET, UPO, Novara, Italy (to GG), AIRC, Investigator Grant IG-21352 (to PS); AIRC 5x1000, Metastases Special Program no. 21198, Milan, Italy (to RF). Funding of the project was provided by an unrestricted contribution from GILEAD Sciences Srl. The funding sources had no role in identifying statements, abstracting data, synthesizing results, grading evidence or preparing the manuscript, or in the decision to submit the manuscript for publication (ISR-17-10250).

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Authors and Affiliations

  1. Hematology Unit AO of Cosenza, Cosenza, Italy

    Massimo Gentile, Vincenzo Fraticelli, Ernesto Vigna & Cirino Botta

  2. Biothecnology Research Unit, AO of Cosenza, Cosenza, Italy

    Massimo Gentile, Fortunato Morabito, Anna Grazia Recchia, Vincenzo Fraticelli, Ernesto Vigna & Cirino Botta

  3. Hematology Oncology Department, Augusta Victoria Hospital, East Jerusalem, Israel

    Fortunato Morabito

  4. Division of Hematology, S. Eugenio Hospital and University of Tor Vergata, Rome, Italy

    Giovanni Del Poeta & Annalisa Biagi

  5. Division of Hematology, Department of Translational and Precision Medicine, ‘Sapienza’ University, Rome, Italy

    Francesca Romana Mauro, Ilaria Del Giudice & Robin Foà

  6. Division of Ematologia, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico di Milano, Milano, Italy

    Gianluigi Reda

  7. Centro di Ricerca Emato-Oncologica (CREO), University of Perugia, Perugia, Italy

    Paolo Sportoletti

  8. Fondazione Universitaria Policlinico A Gemelli di Roma, Roma, Italy

    Luca Laurenti

  9. Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy

    Marta Coscia

  10. Sourasky Medical Center, Institute of Hematology, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Yair Herishanu

  11. Division of Haematology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy

    Marzia Varettoni

  12. Hematology and Stem Cell Transplantation Unit, Ospedale A. Businco, Cagliari, Italy

    Roberta Murru

  13. Division of Hematology, Policlinico, Department of Surgery and Medical Specialties, University of Catania, Catania, Italy

    Annalisa Chiarenza & Francesco Di Raimondo

  14. Division of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

    Adalgisa Condoluci & Davide Rossi

  15. Division of Hematology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy

    Riccardo Moia & Gianluca Gaidano

  16. Division of Hematology, Azienda Ospedaliera SS Arrigo e Biagio e Cesare Arrigo, Alessandria, Italy

    Daniela Pietrasanta

  17. Hematology and Cell Therapy Unit, IRCCS-Istituto Tumori ‘Giovanni Paolo II’, Bari, Italy

    Giacomo Loseto

  18. Department of Hematology, G. Garibaldi Hospital, Catania, Italy

    Ugo Consoli

  19. Clinica di Ematologia Ospedali Riuniti, Ancona, Italy

    Ilaria Scortechini

  20. Clinical and Experimental Onco-Hematology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, (PN), Italy

    Francesca Maria Rossi, Antonella Zucchetto, Riccardo Bomben & Valter Gattei

  21. CNR-IFC, Research Unit of Reggio Calabria, Reggio Calabria, Italy

    Giovanni Tripepi & Graziella D’ Arrigo

  22. UOSD Ematologia ASL Roma 1, Roma, Italy

    Angela Rago

  23. Reparto di Oncoematologia Azienda Ospedaliera Santa Maria di Terni, Terni, Italy

    Ilaria Angeletti

  24. Hematology Section, Department of Medical Sciences, University of Ferrara, Ferrara, Italy

    Gian Matteo Rigolin & Antonio Cuneo

  25. Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel

    Aaron Polliack

Authors
  1. Massimo Gentile
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  2. Fortunato Morabito
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  3. Giovanni Del Poeta
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  4. Francesca Romana Mauro
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  7. Luca Laurenti
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  9. Yair Herishanu
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  10. Anna Grazia Recchia
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  26. Graziella D’ Arrigo
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  27. Angela Rago
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  32. Gian Matteo Rigolin
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  33. Davide Rossi
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  34. Francesco Di Raimondo
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  35. Gianluca Gaidano
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  36. Aaron Polliack
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  37. Antonio Cuneo
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  38. Robin Foà
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  39. Valter Gattei
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Contributions

MG, FM, GDP, FRM, DR, FDR, GG, AP, ACu, RF and VG designed the study, analyzed and interpreted data, and wrote the manuscript; MG, GT, GDA and FM performed statistical analysis; AGR, FMR, AZ, IDG, RB, performed central laboratory tests; GR, PS, LL, MC, YH, MV, RM, ACh, ACo, RMo, DP, GL, UC, IS, VF, EV, CB, AR, IA, AB and GMR provided the patients and collected clinical data; and all authors gave final approval for the manuscript.

Corresponding authors

Correspondence to Massimo Gentile or Valter Gattei.

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The authors declare that they have no conflict of interest.

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Gentile, M., Morabito, F., Del Poeta, G. et al. Survival risk score for real-life relapsed/refractory chronic lymphocytic leukemia patients receiving ibrutinib. A campus CLL study. Leukemia 35, 235–238 (2021). https://doi.org/10.1038/s41375-020-0833-x

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