BALL Score for Relapsed/Refractory CLL
Predicts overall survival in previously treated (relapsed/refractory) CLL starting targeted therapy or chemoimmunotherapy (Soumerai 2019). Four factors, 1 point each: 0–1 low, 2–3 intermediate, 4 high risk.
Score interpretation
24-month overall survival 89.7% (training cohort, Soumerai 2019).
→ Prognostic only — the score does not decide whether to treat (iwCLL 2018 criteria). Treat per guideline; consider clinical trials.
24-month overall survival 79.5% (training cohort).
→ The authors encourage clinical trial participation for intermediate- and high-risk patients; choose therapy per guideline and MDT.
24-month overall survival 55.8% (training cohort).
→ Clinical trial strongly encouraged (novel combinations, CAR-T); MDT discussion, including allogeneic transplant evaluation in fit patients.
Interpretation bands for the BALL Score. Apply clinical judgement and local guidance.
References
- Soumerai JD, et al. Prognostic risk score for patients with relapsed or refractory chronic lymphocytic leukaemia treated with targeted therapies or chemoimmunotherapy: a retrospective, pooled cohort study with external validations. Lancet Haematol. 2019;6(7):e366–e374.
Related
Curated clinical cross-links plus same-class fallbacks.
- Milrinone · Inodilator — Phosphodiesterase III Inhibitor
- Tocilizumab (ICU — Cytokine Storm / COVID-19) · IL-6 Receptor Inhibitor
- Methylene Blue · Guanylate Cyclase / Nitric Oxide Pathway Inhibitor
- Dantrolene sodium · Skeletal muscle relaxant (RyR1 inhibitor)
- Sacubitril-Valsartan · ARNI (Angiotensin Receptor-Neprilysin Inhibitor)
- Ivabradine · If (Funny Current) Inhibitor
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.