Prognostic Models in CML


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Sokal Score1

  • Derives from a multivariate analysis of survival of 813 patients diagnosed with chronic phase CML between 1962 and 1981
  • (0.0116 × (age [years] – 43.4)) + (0.0345 × (spleen size [cm] – 7.51) + (0.188 × ((platelets [109/L]/700)^2 – 0.563)) + (0.0887 × (blasts [%] – 2.10)).
  • Smaller spleen size  (0–6 cm vs > 6 cm) and fewer percentage blasts (0%–1% vs > 1%) were most ­strongly associated with survival.
  • Sokal et al proposed three risk groups: low-risk (Sokal score < 0.8, 39% of patients), intermediate-risk (Sokal score 0.8–1.2, 38% of patients) and high-risk (> 1.2, 23% of patients).

Euro (Hasford) Score2

  • Derives from multivariate analysis of survival of 981 patients with early CML who started treatment between 1983 and 1994.
  • (0.6666 × age [0 when age < 50 years; 1 otherwise]) + (0.0420 × spleen size [cm]) + (0.0584 × blasts [%]) + (0.0413 × eosinophils [%]) + (0.2039 × basophils [0 when basophils < 3%; 1 otherwise]) + (1.0956 × platelet count [0 when platelets < 1,500 × 109/L; 1 otherwise]) × 1,000)
  • Three risk groups were identified: low-risk (score ≤ 780, 40.6% of patients), intermediate-risk (score 781 – 1480, 44.7% of patients) and high-risk (score ≥ 1481, 14.6% of patients).

EUTOS Score3

  • Derived from multivariate analysis of response of 2060 patients treated with imatinib for CML between 2002 and 2006. Score is applied at diagnosis, before therapy.
  • (7 × basophil [%]) + (4 × spleen [cm])
  • Two risk groups were identified: low-risk (score < 87, 79% of patients) and high-risk (score ≥ 87, 21% of patients). ■

References

1. Sokal JE, Cox EB, Baccarani M, et al: Blood 63: 789-799, 1984.

2. Hasford J, Pfirrmann M, Hehlmann R, et al: J Natl Cancer Inst 90: 850-858, 1998.

3. Hasford J, Baccarani M, Hoffmann V, et al: Blood 118:686-692, 2011.

 


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