Within five years, 25% of patients affected by chronic lymphocytic leukemia (CLL) develop a severe infection or need early treatment for CL: 10% of these are at risk of death within a month. To help these patients, the medical community would like to have the ability to identify patients at risk of developing infections soon after they are diagnosed with chronic lymphocytic leukemia.
To solve this serious problem, a team of researchers from the University of Copenhagen and Rigshospitalet made this necessity their mission, and this allowed them to develop an app. The Primary and Clinical Associate Professor Carsten Niemannwho is part of the team responsible for the new studio, said, speaking of the app: “It has improved our chances of identifying those patients, once diagnosed, who will require treatment and close follow-up. “
“We have developed an app that allows doctors to enter the results of previous and current blood tests and then receive data on the patient’s individual risk of a severe disease course“Carsen Niemann said of Department of Clinical Medicine of the University of Copenhagen and the Department of Hematology of the Rigshospitaletthe main hospital in Denmark.
The results of the Research have been published in the scientific journal Communications Medicine.
Chronic lymphocytic leukemia: this is how the dedicated app works
If a patient diagnosed with chronic lymphocytic leukemia is considered to be in the risk group, they may benefit from starting treatment earlier. A new study seeks to determine if this is indeed the case. And while researchers still don’t know whether patients would benefit from starting treatment earlier, the new knowledge will be able to ease the pressure on the healthcare system and patients, explains Carsten Niemann: “Instead of practicing the same frequency of hospital monitoring and follow-up for all patients, we are able to direct efforts on those at high risk of a severe disease course.“.
The app is currently in its pilot phase and has not yet been approved as official help. However, it can be used, even if it does not save the entered data: “We are working on a new project that aims to make another version of the app interact with the medical record system. This requires a series of authorizations, which means that for the moment only the pilot version of the app is available “explained Carsten Niemann.
In order to develop the research, the team of researchers carefully examined a dataset containing 112 million blood tests of 1.3 million Danes, 1,123 of whom have chronic lymphocytic leukemia.. One of the main objectives is to analyze the change over time in the lymphocyte count, which is the concentration of a specific white blood cell in the blood.
“We knew that in the years leading up to diagnosis, patients with chronic lymphocytic leukemia had high numbers of these white blood cells. But we didn’t know how or exactly when the number started to increase. It is these numbers, among others, that we analyzed to predict who is at risk of developing chronic lymphocytic leukemia and who is at risk of infection.“, Specified the first author of the study, the doctor Michael Asger Andersen of the Rigshospitalet Clinical Pharmacology Department.
Patients were also monitored via the Danish Chronic Lymphocytic Leukemia Registry, which allowed the team of scientists to access data on prognosis, treatment and disease course, as well as on patients’ unique mutations in CLL cells: “Another important parameter was the connection between the development of the number of white blood cells and the mutations in the genes responsible for the transformation of cells into cancer cells. This is referred to as the patients’ IGHV mutation status and driver mutations “clarified Michael Asger Andersen.
“We have been able to show that those patients who experience rapid growth of white blood cells – lymphocyte counts – also appear to harbor more mutations that help make cancer cells more aggressive. And vice versa: those who experience a more modest increase in white blood cell numbers, harbor fewer mutations, but mutated IGHV status. That is, the growth model is closely related to the patients’ IGHV mutation status and the driver mutation model“.
The research team subsequently entered these results into the CLL-PLY app: “Many studies have not been able to merge genetic data with the results of routine blood tests; here Danish medical records provide us with a unique advantage “said study co-author, clinical professor and chief physician Christen Lykkegaard Andersen of the Department of Public Health at the University of Copenhagen and the Department of Hematology at Rigshospitalet.
In particular, the researchers benefited from the Copenhagen Primary Care Laboratory (CopLab) database, which constitutes the laboratory data of general practitioners from approximately 2000 to 2016. In parallel with this study, the researchers were involved in a major European collaboration to collect information on mutations and clinical data from many different patients: “We are constantly looking to expand the dataset in order to strengthen the association between routine blood test results and genetic data and thus improve the results in the future “, concluded Christen Lykkegaard Andersen.
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