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Chronic Leukemia

Jabbour E, Cortes J, Nazha A et al.

University of Texas MD Anderson Cancer Center, Houston, TX, USA.

 Blood 2012;119:4524–6.

Editor’s note: The Sokal score, using a combination of age, platelet count, spleen size, and peripheral blood blast percentage, can be used to predict outcome of patients with chronic-phase chronic myeloid leukemia (CML). Although the score was devised in the pre-imatinib era, it can still be predictive of response and survival in patients with CML treated with imatinib. This suggests that higher risk patients could be observed more closely and selected for early intervention with the more recently available second-generation tyrosine kinase inhibitors (TKIs). The Sokal score, however, is relatively limited in its predictive power and is also hindered by its complexity. In an attempt to improve on the Sokal score, a simple-to-calculate EUTOS (European Treatment and Outcomes Study) prognostic score was recently devised (Blood 2011;118:686–92); this predicts outcome of patients treated with first-line imatinib using only the basophil count and spleen size (EUTOS score = [7 × basophils] + [4 × spleen size]). The EUTOS score stratifies patients into two risk groups: high-risk (score >87) and low-risk (score ≤87). The original study demonstrated that 34% of high-risk patients failed to enter complete cytogenetic remission (CCyR) as opposed to 14% of low-risk patients. The 5-year progression-free survival rate was 82% (95% confidence interval [CI] 73–89%) for high-risk patients and 90% (95% CI 88–92%) for low-risk patients (log-rank test p=0.0069).

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