CLLAF SCORE-A New Risk Score for Predicting Atrial Fibrillation in Treatment-Naive CLL Patients Initiating First- and Second-Generation BTK Inhibitor Therapy.

IF 2.3 3区 医学 Q2 HEMATOLOGY European Journal of Haematology Pub Date : 2025-03-12 DOI:10.1111/ejh.14400
Tamar Tadmor, Guy Melamed, Hilel Alapi, Lior Rokach
{"title":"CLLAF SCORE-A New Risk Score for Predicting Atrial Fibrillation in Treatment-Naive CLL Patients Initiating First- and Second-Generation BTK Inhibitor Therapy.","authors":"Tamar Tadmor, Guy Melamed, Hilel Alapi, Lior Rokach","doi":"10.1111/ejh.14400","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>One of the limiting toxicities of BTKi is the development of atrial fibrillation (AF), with an incidence of 3%-16%.</p><p><strong>Aim: </strong>This study aimed to identify patients with chronic lymphocytic leukemia (CLL) starting both first- and second-generation BTKis who are at high risk of developing AF using a machine learning approach.</p><p><strong>Methods: </strong>The CLL cohort is based on data obtained from electronic medical records from Maccabi, the second-largest healthcare organization in Israel. The optimal scoring model was determined using the Risk-calibrated Supersparse Linear Integer Model (RiskSLIM) algorithm.</p><p><strong>Results: </strong>A total of 3964 patients with a CLL diagnosis were available in the database. Of these, 208 patients started BTKi during the study period (125 on ibrutinib and 83 on acalabrutinib), and 16 patients developed AF during follow-up. In addition to well-established factors such as age, sex, and hypertension, the algorithm detected other factors associated with a high risk for AF: type of BTKi used, low eGFR, elevated absolute monocytes (> 1100/μL), elevated CRP, elevated CK, and elevated B2MG (> 2.5 mg/L). Based on the total AF-free survival (AFS), we identified three main risk groups: low (0-6), intermediate (7-11) and high (≥ 12). The median AF-free survival (AFS) was 28 and 56 months for the high-risk and intermediate-risk groups, respectively, and was not reached for the low-risk group. The difference between the groups was statistically significant (p = 0.0013).</p><p><strong>Conclusion: </strong>Our novel score has a high concordance index for predicting the development of AF in patients with CLL treated with first- and second-generation BTKis. It combines age, sex, medical history, and laboratory tests associated with inflammatory status and disease burden and can be applied in clinical settings worldwide.</p>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":" ","pages":""},"PeriodicalIF":2.3000,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Journal of Haematology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ejh.14400","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: One of the limiting toxicities of BTKi is the development of atrial fibrillation (AF), with an incidence of 3%-16%.

Aim: This study aimed to identify patients with chronic lymphocytic leukemia (CLL) starting both first- and second-generation BTKis who are at high risk of developing AF using a machine learning approach.

Methods: The CLL cohort is based on data obtained from electronic medical records from Maccabi, the second-largest healthcare organization in Israel. The optimal scoring model was determined using the Risk-calibrated Supersparse Linear Integer Model (RiskSLIM) algorithm.

Results: A total of 3964 patients with a CLL diagnosis were available in the database. Of these, 208 patients started BTKi during the study period (125 on ibrutinib and 83 on acalabrutinib), and 16 patients developed AF during follow-up. In addition to well-established factors such as age, sex, and hypertension, the algorithm detected other factors associated with a high risk for AF: type of BTKi used, low eGFR, elevated absolute monocytes (> 1100/μL), elevated CRP, elevated CK, and elevated B2MG (> 2.5 mg/L). Based on the total AF-free survival (AFS), we identified three main risk groups: low (0-6), intermediate (7-11) and high (≥ 12). The median AF-free survival (AFS) was 28 and 56 months for the high-risk and intermediate-risk groups, respectively, and was not reached for the low-risk group. The difference between the groups was statistically significant (p = 0.0013).

Conclusion: Our novel score has a high concordance index for predicting the development of AF in patients with CLL treated with first- and second-generation BTKis. It combines age, sex, medical history, and laboratory tests associated with inflammatory status and disease burden and can be applied in clinical settings worldwide.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
5.50
自引率
0.00%
发文量
168
审稿时长
4-8 weeks
期刊介绍: European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.
期刊最新文献
Predictive and Prognostic Significance of Patient-Reported Outcomes for Survival and Adverse Events in Daratumumab-Treated Multiple Myeloma. CLLAF SCORE-A New Risk Score for Predicting Atrial Fibrillation in Treatment-Naive CLL Patients Initiating First- and Second-Generation BTK Inhibitor Therapy. Targeting the Immune Microenvironment in Chronic Lymphocytic Leukemia: An Evolving Therapeutic Strategy. Clinical Impact of Continuous Dasatinib Administration on the Prognosis of Patients With BCR::ABL1 Acute Lymphoblastic Leukemia: Result of the Prospective MRD2014 Study Conducted by Fukuoka Blood and Marrow Transplantation Group (FBMTG). Further Reflections on 6-MP Adherence and Habit Strength: The Impact of Dose Adjustment Complexity and Caregiver Burden.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1