Improved prediction of clinical outcome in chronic myeloid leukemia

We sought to develop and compare prognostic models, based on clinical and/or morphometric diagnostic data, to enable better prediction of complete cytogenetic response (CCgR). This prospective longitudinal study included a consecutive series of patients with chronic myeloid leukemia (CML) who were s...

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Bibliographic Details
Published in:International journal of hematology 2015-02, Vol.101 (2), p.173-183
Main Authors: Ojbasic, Irena, Macukanovic-golubovic, Lana, Mihailovic, Dragan, Vucic, Miodrag, Lukic, Stevo
Format: Article
Language:English
Subjects:
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biopsy
Bone Marrow - pathology
Clinical outcomes
Cytogenetic Analysis
Female
Hematology
Humans
Immunohistochemistry
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - diagnosis
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - drug therapy
Leukemia, Myelogenous, Chronic, BCR-ABL Positive - mortality
Logistic Models
Male
Medicine
Medicine & Public Health
Middle Aged
Models, Statistical
Neovascularization, Pathologic
Odds Ratio
Oncology
Original Article
Prognosis
Registries
Reproducibility of Results
ROC Curve
Time Factors
Treatment Outcome
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Summary:We sought to develop and compare prognostic models, based on clinical and/or morphometric diagnostic data, to enable better prediction of complete cytogenetic response (CCgR). This prospective longitudinal study included a consecutive series of patients with chronic myeloid leukemia (CML) who were started on imatinib therapy. Logistic regression analysis using backward selection was performed with CCgR at 6, 12, and 18 months as the outcome variables. We evaluated both calibration and discrimination of the model. Internal validation of the model was performed with bootstrapping techniques. A total of 40 patients on imatinib therapy were included in the final analysis. Of these, 25 (62.5 %), 29 (72.5 %), and 32 (80 %), respectively, achieved CCgR at 6, 12, and 18 months after initiation of imatinib. Models included EUTOS score on diagnosis and one of the following morphometric parameters: microvascular density, length of the minor axis, area or circularity of the blood vessel. Models including morphometric parameters and EUTOS score were superior for prediction of CCgR at 6, 12, and 18 months. In particular, the superior models showed better specificity than EUTOS score alone. Using morphometric parameters in conjunction with EUTOS score improves prediction of CCgR. If validated, these models could aid in individual patient risk stratification.
ISSN:0925-5710
1865-3774
DOI:10.1007/s12185-014-1726-4