In short videos with accompanying text, Dr. Brian Koffman, the Executive Vice President (EVP) and Chief Medical Officer (CMO) of the CLL Society, takes us through his “Top 12” abstracts from ASCO or the American Society of Clinical Oncology Annual Meeting held virtually in May, 2020.
ASCO 2020: Cause of death in patients with newly diagnosed chronic lymphocytic leukemia (CLL) stratified by the CLL-International Prognostic Index (CLL-IPI)
More than one of us has heard the line that we will die with our chronic lymphocytic leukemia, not from it.
If that was true before the modern era, how much truer is it now that we have targeted therapies and potent immunotherapies to control our disease?
What do the facts show?
Dr. Yucai Wang led a team from Mayo researching what actually happens to us, stratified by our risk using the CLL-International Prognostic Index (CLL-IPI).
In the way of background, CLL-IPI was first used in 2016 and has proven to be a helpful prognostic tool for CLL patients.
Here is a link to the original ASH news.
Here is the table from that paper:
And here is the scoring:
- Low-risk patients (score = 0-1)
- Intermediate risk (score = 2-3)
- High risk (score = 4-6)
- Very-high risk (score = 7-10)
This link will do the calculation for you.
Now let’s see what the researchers found.
- The study involved 1,276 patients newly diagnosed between 1/2000-12/2019.
- Median age at diagnosis was 63 years old
- 880 (69%) males
- 35% were low risk, 35% had intermediate risk, and 30% were high or very high risk
- The overall cause of death was:
- CLL progression in 35%
- Infection in 6%
- Second malignancy 46%
- CLL-unrelated in 21%
- Unknown in 23%
- The rates of death due to CLL progression were higher than the rates due to CLL-related complications or due to CLL-unrelated causes in the CLL-IPI high/very high-risk group, but not the CLL-IPI low or intermediate risk groups.
We are still dying directly or indirectly from our CLL and it is a different issue depending on our CLL-IPI risk assessment.
For those with high/very high-risk disease, better control of the chronic lymphocytic leukemia is critically needed to keep us alive.
For those in the in the low or intermediate risk category, the primary need is to reverse the immune dysfunction that leads to infections and secondary cancers.This important research reminds us that CLL is hardly a solved problem.
Please enjoy my brief video overview of this research.
Stay strong and safe, we are all in this together.
Brian Koffman MDCM (retired) MS Ed
Co-Founder, Executive VP and Chief Medical Officer
CLL Society, Inc.