{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:35:35Z","timestamp":1787841335447,"version":"build-2784847793"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The variable clinical course of chronic lymphocytic leukemia (CLL) and the lack of consensus on followup and treatment strategies have necessitated a prognostic model for identifying high-risk patients at the time of diagnosis. Methods: We involved a retrospective analysis of demographic and clinical characteristics of 212 patients diagnosed with Binet stage A CLL and thus eligible for risk stratification by both the International Prognostic Score for Early-stage CLL (IPS-E) and the alternative IPS-E (AIPS-E). We evaluated the applicability of these prognostic indices in our young, Middle Eastern cohort (median age 59 at diagnosis). Results: During the study period with a median followup of 3.5 years, 67 patients (32 %) experienced progression to first treatment and cumulative incidence of treatment was 13 % at 1 year and 28 % at 3 years after diagnosis. Sixty-nine (51 % of the 136 with a known value) patients harbored an unmutated immunoglobulin heavy chain gene (IGHV) and 21 (10 %) an 11q or 17p deletion with 11 % lacking FISH results. For each early-stage CLL prognostic index, more patients were identified as high-risk for disease progression (51 % of 124 patients evaluable for IPS-E; 42 % of 109 patients evaluable for AIPS-E) than intermediate-risk and low-risk. Multivariable models involving the IPS-E and AIPS-E components revealed that unmutated IGHV and elevated absolute lymphocyte count were significant predictors of earlier treatment requirement. Both prognostic scores were discriminative of time to first treatment (log-rank p &lt; 0.001; c-statistics of 0.74 for IPS-E and 0.69 for AIPS-E).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Although clarity on clinical behavior with regard to initiation of treatment remains elusive, IPS-E and AIPS-E are valuable tools for identifying high-risk patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.56875\/2589-0646.1117","type":"journal-article","created":{"date-parts":[[2024,3,31]],"date-time":"2024-03-31T14:56:00Z","timestamp":1711896960000},"page":"137-145","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Predicting Stage Progression in Binet Stage a Chronic Lymphocytic Leukemia"],"prefix":"10.4103","volume":"17","author":[{"given":"Salem H.","family":"Alshemmari","sequence":"first","affiliation":[{"name":"Department of Medicine, Kuwait University, State of Kuwait, Kuwait"},{"name":"Department of Hematology, Kuwait Cancer Center, State of Kuwait, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mazyad","family":"Almazyad","sequence":"additional","affiliation":[{"name":"Department of Medicine, Farwaniya Hospital, State of Kuwait, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Alsarraf","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kuwait University, State of Kuwait, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Kunhikrishnan","sequence":"additional","affiliation":[{"name":"Department of Hematology, Kuwait Cancer Center, State of Kuwait, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asha M.","family":"Isaac","sequence":"additional","affiliation":[{"name":"Department of Medicine, Kuwait University, State of Kuwait, Kuwait"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Kaempf","sequence":"additional","affiliation":[{"name":"Knight Cancer Institute, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,3,22]]},"reference":[{"issue":"12","key":"R1-20241211","doi-asserted-by":"crossref","first-page":"4990","DOI":"10.1182\/blood.V87.12.4990.bloodjournal87124990","article-title":"National Cancer Institute-sponsored Working Group guidelines for chronic lymphocytic leukemia: revised guidelines for diagnosis and treatment","volume":"87","author":"Cheson","year":"1996","journal-title":"Blood"},{"issue":"5","key":"R2-20241211","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1111\/j.1365-2141.2007.06856.x","article-title":"Chronic lymphocytic leukaemia and small 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