The International Prognostic Index for Chronic Lymphocytic Leukemia (CLL-IPI) is a risk stratification tool designed to predict the survival outcomes of patients diagnosed with Chronic Lymphocytic Leukemia. It is used to guide clinical decision-making and to tailor treatment strategies according to the patient's risk profile.
The CLL-IPI incorporates five primary components: age, clinical stage, serum β2 microglobulin levels, IGHV mutational status, and TP53 status. Each component is assigned a score based on the patient's specific characteristics. For instance, patients aged over 65 years, those with a Binet B-C or Rai I-IV clinical stage, serum β2 microglobulin levels over 3.5 mg/L, unmutated IGHV, and TP53 abnormalities (either deletion 17p detected by FISH or TP53 mutation detected by sequencing) are assigned higher scores, reflecting a worse prognosis.
The total score, which ranges from 0 to 10, is calculated by summing the scores of each component. This total score is then used to categorize patients into four risk groups: low risk (score <= 1), intermediate risk (score <= 3), high risk (score <= 6), and very high risk (score <= 10). These risk groups correspond to 5-year survival rates of 93.2%, 79.3%, 63.3%, and 23.3%, respectively.
By providing a quantitative assessment of prognosis, the CLL-IPI aids clinicians in identifying patients who may benefit from more aggressive treatment strategies, while sparing those with a lower risk profile from unnecessary interventions.
Reference
International CLL-IPI working group. An international prognostic index for patients with chronic lymphocytic leukaemia (CLL-IPI): a meta-analysis of individual patient data. Lancet Oncol. 2016 Jun;17(6):779-790.
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