A predictive tool for early-stage CLL

In this issue of Blood, Condoluci et al report that, using a large international cohort of 4933 patients from 11 groups, they have developed an international prognostic score (IPS-E) for predicting time to first treatment (TTFT) in patients with asymptomatic, early-stage CLL.1 Although there have been multiple past publications on prognostication in CLL, previous models have predominantly addressed overall survival as the end point of interest.2 Although survival is obviously of interest for both physicians and patients, the long survival duration of patients with early-stage CLL3 means that a more immediately relevant and often asked question is: Doctor, how long do I have before I have to put my life on hold and accept treatment for my leukemia?