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Performance of Sokal and Eutos Scores for Predicting Cytogenetic and Molecular Response in Newly Diagnosed Chronic Myeloid Leukemia-Chronic Phase Patients on Imatinib

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Abstract

Sokal index was developed in the pre-imatinib era to predict and prognosticate the outcome of Chronic myeloid leukemia (CML) patients. In the Imatinib era, a new scoring system called EUTOS scoring system has been validated as a predictive marker in CML. The scores have shown variable correlation with complete cytogenetic response (CCyR) and major molecular response (MMR). To assess the performance of Sokal score and EUTOS score as a predictive marker for CCyR and MMR for newly diagnosed CML-CP patients treated with TKIs. 273 patients with newly diagnosed CML were included in the study. They were treated with upfront imatinib. They were followed up for a median period of 3 years. Cytogenetic and Molecular response to the treatment were monitored regularly. Out of 273 patients, 174 patients (63 %) were having low EUTOS score and 99 (37 %) were having high EUTOS score. Patients with low, intermediate and high sokal scores were 237 (86.8 %), 28 (10.3 %) and 8 (2.9 %) respectively. 122 patients with low EUTOS score achieved CCyR within 18 months compared to 42 patients with high EUTOS score (p = 0.000).113 patients with low EUTOS score achieved MMR in 18 months compared to 33 patients with high EUTOS score (p = 0.000). 148, 14, 2 patients with low, intermediate and high Sokal score respectively have achieved CCyR in 18 months (p = 0.054). 133, 11, 2 patients with low intermediate and high sokal score respectively have achieved MMR in 18 months.(p = 0.06). EUTOS is better than Sokal score in predicting the outcome of patients of CML treated with imatinib.

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References

  1. Rowley JD (1973) A new consistent abnormality in chronic myelogenous leukaemia identified by quinacrine fluorescence and Giemsa staining. Nature 243:290–293

    Article  CAS  PubMed  Google Scholar 

  2. Heisterkamp N, Stam K, Groffen J, de Klein A, Grosveld G (1985) Structural organization of the bcr gene and its role in the Ph’ translocation. Nature 315:758–761

    Article  CAS  PubMed  Google Scholar 

  3. Sokal JE, Cox EB, Baccarani M et al (1984) Prognostic discrimination in “good-risk” chronic granulocytic leukemia. Blood 63:789–799

    CAS  PubMed  Google Scholar 

  4. Hasford J, Pfirrmann M, Hehlmann R et al (1998) A new prognostic score for survival of patients with chronic myeloid leukemia treated with interferon alfa. J Natl Cancer Inst 90(11):850–858

    Article  CAS  PubMed  Google Scholar 

  5. Baccarani M, Cortes J, Pane F et al (2009) Chronic myeloid leukemia: an update of concepts and management recommendations of European LeukemiaNet. J Clin Oncol 27(35):6041–6051

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Pavey T, Hoyle M, Ciani O, Crathorne L, Jones-Hughes T, Cooper C et al (2012) Dasatinib, nilotinib and standard-dose imatinib for the first-line treatment of chronic myeloid leukaemia: systematic reviews and economic analyses. Health Technol Assess 16(42):i–vii

    Article  Google Scholar 

  7. O’Brien SG, Guilhot F, Larson RA et al (2003) Imatinib compared with interferon and low-dose cytarabine for newly diagnosed chronic-phase chronic myeloid leukemia. N Engl J Med 348:994–1004

    Article  PubMed  Google Scholar 

  8. Hughes T, Deininger M, Hochhaus A et al (2006) Monitoring CML patients responding to treatment with tyrosine kinase inhibitors: review and recommendations for harmonizing current methodology for detecting BCR-ABL transcripts and kinase domain mutations and for expressing results. Blood 108:28–37

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Druker JB, Guilhot F, O’Brien S et al (2006) Five-year follow-up of patients receiving imatinib for chronic myeloid leukemia. N Engl J Med 355:2408–2417

    Article  CAS  PubMed  Google Scholar 

  10. Hasford J, Baccarani M, Hoffmann V, Guilhot J, Saussele S, Rosti G et al (2011) Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score. Blood 118:686–692

    Article  CAS  PubMed  Google Scholar 

  11. Sokal JE, Baccarani M, Russo D (1988) Staging and prognosis in chronic myelogenous leukemia. Semin Hematol 25:49–61

    CAS  PubMed  Google Scholar 

  12. Muller-Berat CN, Wantzin GL, Philip P, Baccarani M, Killmann S-A (1977) Agar culture studies of bone marrow, blood, spleen, and liver in chronic myeloid leukemia. Leuk Res 1:123–131

    Article  Google Scholar 

  13. Schemionek M, Spieker T, Kerstiens L, Elling C, Essers M, Trumpp A et al (2011) Leukemic spleen cells are more potent than bone marrow-derived cells in a transgenic mouse model of CML. Leukemia 26:1030–1037

    Article  PubMed  Google Scholar 

  14. Hoffmann VS, Baccarani M, Lindoerfer D et al (2013) The EUTOS prognostic score: review and validation in 1288 patients with CML treated frontline with imatinib. Leukemia 27:2016–2022

    Article  CAS  PubMed  Google Scholar 

  15. Marin D, Ibrahim AR, Goldman JM (2011) European treatment and outcome study (EUTOS) score for chronic myeloid leukemia still requires more confirmation. J Clin Oncol 29:3944–3945

    Article  PubMed  Google Scholar 

  16. Pagnano KB, Lorand-Metze I, Miranda ECM, et al (2012) EUTOS score is predictive of event-free survival, but not for progression-freeand overall survival in patients with early chronic phase chronic myeloidleukemia treated with imatinib: a single Institution experience. Blood, 120 (ASH abstract no. 1681)

  17. Tiribelli M, Bonifacio M, Calistri E, et al (2012) EUTOS score identifies cases with poor outcome in patients with early phase chronic myeloid leukemia though not predictive for optimal response to imatinib. Blood, 120 (ASH abstract 3778)

  18. Than H, Kuan L, Seow CH, Li et al (2012) The EUTOS score is highly predictive for clinical outcome and survival in Asian patients with early chronic phase chronic myeloid leukemia treated with imatinib. Blood, 120 (ASH abstract 3758)

  19. Yahng S-A, Jang E-J, Choi SY, et al (2012) Comparison of Sokal, Hasford and EUTOS scores in term of long-term treatment outcome according to the risks in each prognostic model: a single center data analysed in 255 early chronic phase chronic myeloid leukemia patients treated with frontline imatinib mesylate. Blood, 120: (ASH abstract no. 2794)

  20. Jabbour E, Cortes J, Nazha A, O’Brien S et al (2012) EUTOS score is not predictive for survival and outcome in patients with early chronic phase chronic myeloid leukemia treated with tyrosine kinase inhibitors:a single institution experience. Blood 119:4524–4526

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Baccarani M, Deininger MW, Rosti G et al (2013) European LeukemiaNet recommendations for the management of chronic myeloid leukemia: 2013. Blood 122(6):872–884

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We are grateful to the staff members of Department of Medical Oncology, Kidwai Memorial Institute of Oncology for helping us in making this manuscript.

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Correspondence to Sandip Ganguly.

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Ganguly, S., Lakshmaiah, K.C., Jacob, L.A. et al. Performance of Sokal and Eutos Scores for Predicting Cytogenetic and Molecular Response in Newly Diagnosed Chronic Myeloid Leukemia-Chronic Phase Patients on Imatinib. Indian J Hematol Blood Transfus 33, 82–86 (2017). https://doi.org/10.1007/s12288-016-0667-x

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