Abstract

Trajkova S.*, Cevreska L., Stojanovic A., Ivanovski M., Petreska-Dukovska V., Popova-Labachevska M., Panovska-Stavridis I.

ABSTRACT

Introduction: Chronic lymphocytic leukemia (CLL) in its clinical course is a heterogeneous clonal lymph proliferative 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 nomogram-prognostic 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 International Working Group on Cholera (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.