International Prognostic Index for Chronic Lymphocytic Leukemia (CLL-IPI)

Why did you develop the CLL-IPI? Was there a particular clinical experience or patient encounter that inspired you to create this tool for clinicians?

We developed the CLL-IPI because we realized that the clinical staging systems did not separate high risk patients well enough in the era of new therapies (chemoimmunotherapies) (Pflug et al, Blood 2014).

What pearls, pitfalls and/or tips do you have for users of the CLL-IPI? Do you know of cases when it has been applied, interpreted, or used inappropriately?

The score should be applied for prognostication but not for determining treatment indication. As of today, indication for treatment is determined by symptoms of disease (and sometimes clinical staging).

What recommendations do you have for doctors once they have applied the CLL-IPI? Are there any adjustments or updates you would make to the score based on new data or practice changes?

The CLL-IPI will be evaluated in the era of novel targeted agents to see whether it applies for patients treated with agents such as ibrutinib, idelalisib, or venetoclax.

How do you use the CLL-IPI in your own clinical practice? Can you give an example of a scenario in which you use it?

I use it for all CLL patients.

Any other research in the pipeline that you’re particularly excited about?

I am excited about the potent therapeutic efficacy of novel agents in CLL, and by studies of clonal evolution of CLL under targeted therapies, as well as strategies to prevent it.

Michael Hallek, MD, is an internist specializing in hematology and oncology in Cologne, Germany. He also serves as chair of the internal medicine department at the University of Cologne and director of the Center for Integrated Oncology. Dr. Hallek's primary research interests include the development of specific molecular therapies for leukemia.