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

Trajkova Sanja; Cevreska Lidija; Ivanovski Martin; Dukovski Dusko; Simjanovska-Popova Marija; Stankovik Svetlana; Panovska-Stavridis Irina

doi:doi:10.11648/j.sjcm.20140306.15

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

Trajkova Sanja, Cevreska Lidija, Ivanovski Martin, Dukovski Dusko, Simjanovska-Popova Marija, Stankovik Svetlana, Panovska-Stavridis Irina

Published in Science Journal of Clinical Medicine (Volume 3, Issue 6)

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.

Published in	Science Journal of Clinical Medicine (Volume 3, Issue 6)
DOI	10.11648/j.sjcm.20140306.15
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), 2014. Published by Science Publishing Group

Keywords

CLL, Prognostic Index, Nomogram, Prognosis

References

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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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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://article.sciencepublishinggroup.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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Author Information

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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APA Style

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

Copy | Download

@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://article.sciencepublishinggroup.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}
}

Copy | Download

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  -

Copy | Download