Cause of death in patients with newly diagnosed chronic lymphocytic leukemia (CLL) stratified by the CLL-International Prognostic Index

This is the authors' abstract. We don't add key points for this paper.

Chronic lymphocytic leukemia (CLL) is an indolent B-cell lymphoproliferative disorder that is considered incurable [ 1 ]. The clinical presentation of CLL is heterogeneous and the rate of progression is variable. Many patients have an indolent disease course and can be observed for years, while a subset of patients experience rapid disease progression with symptoms and/or bone marrow failure requiring treatment. A recent advance in risk stratification has been the CLL-International Prognostic Index (CLL-IPI), which integrates major clinical and molecular prognostic factors into a single risk score. Specifically, CLL-IPI uses age, Binet or Rai stage, beta-2 microglobulin, immunoglobulin heavy-chain gene variable region ( IGHV) mutation status, and TP53 disruption status (17p deletion or somatic TP53 mutation) to stratify patients with newly diagnosed CLL into four risk groups with distinct prognosis [ 2 ]. Subsequent studies have shown that CLL-IPI can predict time to first treatment (TTFT) and overall survival (OS) in newly diagnosed CLL [ 2 , 3 , 4 , 5 ]. Although CLL primarily affects older adults in whom comorbidities can be competing causes of mortality, we previously showed that CLL progression and CLL-related complications (including infections and second malignancies) were the leading causes of death in patients with newly diagnosed CLL, regardless of age and comorbidities [ 6 ]. In this study, we sought to investigate if the causes of death in patients with newly diagnosed CLL would differ according to the CLL-IPI risk group.