External validation on a prospective basis of a nomogram for predicting the time to first treatment in patients with chronic lymphocytic leukemia

摘要: BACKGROUND: A nomogram that incorporates traditional and newer prognostic factors to identify patients with chronic lymphocytic leukemia (CLL) who are at high risk of receiving therapy was developed by investigators The University Texas M. D. Anderson Cancer Center (MDACC). Because the model required validation before its extensive use could be recommended, authors sought externally validate in an independent, community-based cohort CLL. METHODS: In total, 328 previously untreated newly diagnosed, asymptomatic, Binet stage A CLL from different primary hematology centers were registered on a prospective basis during 2006 2010 observational database Italian Lymphoma Study Group considered suitable for external model. RESULTS: A total point score calculated each patient using formula proposed MDACC investigators, median 19.9 (range, 0-69.5). Furthermore, when evaluated as continuous variable (ie, measuring increase), associated time first treatment (hazard ratio [HR], 1.04; 95% confidence interval [CI], 1.02-1.05; P < .0001). Receiver operating characteristic analysis identified 25 (area under curve; 0.64; sensitivity, 61.5; specificity, 72.1; .0001) best threshold capable separating needed did not (HR, 3.27; CI, 2,07-5.18; index category also remained predictor limited Rai 0 disease 4.05; 2.25-7.52; Finally, goodness-of-fit test demonstrated had significantly good fit 2 years (correlation coefficient [r2] = 0.966; .002). CONCLUSIONS: The current results confirmed ability predict among early extended utility those disease. In addition, actual predicted outcomes revealed agreement, suggesting that, externally, provided well calibrated. 2013. © 2012 American Society.