{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:44:58Z","timestamp":1764603898428,"version":"3.40.5"},"reference-count":49,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Current chronic lymphocytic leukemia (CLL) International Prognostic Index (IPI) stratifies patients based on clinical, molecular, and biochemical features; however, B\u2010cell markers also influence CLL outcomes. Here, prognostic roles of CD11c, CD38, and CD49d were first evaluated, and then an immunophenotypic score was combined with CLL\u2010IPI for risk stratification of CLL patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 171 CLL subjects were included, and surface marker expression was assessed by flow cytometry. Levels \u226530% were chosen as cut\u2010off of positivity to a marker; then values of 1 (for CD11c and CD38) or 3 (for CD49d) were assigned and scores determined for each patient's clone immunophenotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CD49d positivity was significantly associated with simultaneous expression of CD11c and\/or CD38, unmutated <jats:italic>IGHV<\/jats:italic> status, and higher \u03b22\u2010microglobulin levels compared to those with CD49d negativity. Moreover, CD49d<jats:sup>+<\/jats:sup> patients experienced a shorter progression\u2010free survival and time to treatment. When the immunophenotypic score was combined with CLL\u2010IPI, patients with high\u2010risk immunophenotype had a significantly lower time\u2010to\u2010treatment regardless CLL\u2010IPI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggested clinical utility of an integrated prognostic score for better risk stratification of CLL patients. These results require further validation in prospective larger studies.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ejh.13833","type":"journal-article","created":{"date-parts":[[2022,7,24]],"date-time":"2022-07-24T14:18:18Z","timestamp":1658672298000},"page":"483-493","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Implementation of International Prognostic Index with flow cytometry immunophenotyping for better risk stratification of chronic lymphocytic leukemia"],"prefix":"10.1111","volume":"109","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7492-6848","authenticated-orcid":false,"given":"Valentina","family":"Giudice","sequence":"first","affiliation":[{"name":"Hematology and Transplant Center University Hospital \u201cSan Giovanni di Dio e Ruggi d'Aragona\u201d  Salerno Italy"},{"name":"Department of Medicine, Surgery, and Dentistry University of Salerno  Baronissi 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