Abstract:
Objective To compare the effectiveness of four prognostic scoring systems in predicting the efficacy and prognosis of patients newly diagnosed with chronic myeloid leukemia (CML). Identifying patients with CML at significantly low response and survival rates favors early intervention. We also evaluated the ability of the European Treatment and Outcome Study (EUTOS) long-term survival (ELTS) score as a new indicator of CML-related death.
Methods We performed a retrospective analysis of 172 patients with chronic myeloid leukemia-chronic phase (CML-CP) who received first-line treatment with imatinib at our hospital from January 2010 to December 2019. Sokal, Hasford, EUTOS, and ELTS scores were applied. The patients were divided into various risk groups, and scoring systems were compared in terms of the overall survival (OS), progression-free survival (PFS), major molecular response (MMR), CML-related deaths, other treatment effects, and impact of follow-up evaluations.
Results In 172 patients, the EUTOS and ELTS scores could better predict the cumulative incidence of MMR (P < 0.001, P=0.015), OS (P < 0.001, P=0.001), and PFS (P < 0.001, P < 0.001). However, both Sokal and Hasford scores failed to predict the response and outcome of CML after treatment with imatinib (P>0.05). ELTS scores were statistically significant in CML-related deaths (P < 0.01) while Sokal, Hasford, and EUTOS scores showed no significant differences (P=0.07, P=0.10, P=0.08). ELTS scores were more accurate in predicting CML-related deaths than the other three prognostic scores.
Conclusions In predicting the outcome of patients with CML treated with imatinib, the EUTOS and ELTS scores are better than the Sokal and Hasford scores. The new ELTS score provides a better prospective assessment of the long-term anti-leukemia efficacy of first-line imatinib in patients with CML.
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