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@ARTICLE{Bloehdorn:167949,
author = {J. Bloehdorn and J. Krzykalla$^*$ and K. Holzmann and A.
Gerhardinger and B. M. C. Jebaraj and J. Bahlo and K.
Humphrey and E. Tausch and S. Robrecht and D. Mertens$^*$
and C. Schneider and K. Fischer and M. Hallek and H. Döhner
and A. Benner$^*$ and S. Stilgenbauer},
title = {{I}ntegrative prognostic models predict long-term survival
after immunochemotherapy in chronic lymphocytic leukemia
patients.},
journal = {Haematologica},
volume = {107},
number = {3},
issn = {1592-8721},
address = {Pavia},
publisher = {Ferrata Storti Foundation64433},
reportid = {DKFZ-2021-00660},
pages = {615-624},
year = {2022},
note = {2022Volume 107(3):615-624 / #LA:C060#},
abstract = {Chemoimmunotherapy with fludarabine, cyclophosphamide and
rituximab can induce longterm remissions in patients with
chronic lymphocytic leukemia. Treatment efficacy with
Bruton's tyrosine kinase inhibitors was found similar to
fludarabine, cyclophosphamide and rituximab in untreated
chronic lymphocytic leukemia patients with a mutated
immunoglobulin heavy chain variable gene. To identify
patients who specifically benefit from fludarabine,
cyclophosphamide and rituximab, we developed integrative
models including established prognostic parameters and gene
expression profiling. Gene expression profiling was
conducted on n=337 CLL8 trial samples, 'core' probe sets
were summarized on gene levels and RMA normalized.
Prognostic models were built using penalized Cox
proportional hazards models with the smoothly clipped
absolute deviation penalty. We identified a prognostic
signature of less than a dozen genes, which substituted for
established prognostic factors, including TP53 and
immunoglobulin heavy chain variable gene mutation status.
Independent prognostic impact was confirmed for treatment,
β2-microglobulin and del(17p) regarding overall survival
and for treatment, del(11q), del(17p) and SF3B1 mutation for
progression-free survival. The combination of independent
prognostic and gene expression profiling variables performed
equal to models including only established non-gene
expression profiling variables. Gene expression profiling
variables showed higher prognostic accuracy for patients
with long progression-free survival compared to categorical
variables like the immunoglobulin heavy chain variable gene
mutation status and reliably predicted overall survival in
CLL8 and an independent cohort. Gene expression profiling
based prognostic models can help to identify patients who
specifically benefit from fludarabine, cyclophosphamide and
rituximab treatment. The CLL8 trial is registered under
EUDRACT- 2004-004938-14 and ClinicalTrials.gov Identifier
NCT00281918.},
cin = {C060 / B061},
ddc = {610},
cid = {I:(DE-He78)C060-20160331 / I:(DE-He78)B061-20160331},
pnm = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
pid = {G:(DE-HGF)POF4-313},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:33730841},
doi = {10.3324/haematol.2020.251561},
url = {https://inrepo02.dkfz.de/record/167949},
}