Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score

full-text ►Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score: "Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: the EUTOS score

1. Joerg Hasford1,*,
2. Michele Baccarani2,*,
3. Verena Hoffmann1,
4. Joelle Guilhot3,
5. Susanne Saussele4,
6. Gianantonio Rosti2,
7. François Guilhot3,
8. Kimmo Porkka5,
9. Gert Ossenkoppele6,
10. Doris Lindoerfer1,
11. Bengt Simonsson7,
12. Markus Pfirrmann1, and
13. Rudiger Hehlmann4

+ Author Affiliations

1. 1Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie, Ludwig-Maximilians-Universität, München, Germany;
2. 2Department of Hematology and Oncology L. and A. Seràgnoli, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy;
3. 3Les Centres d'Investigation Clinique Inserm, Centre Hospitalier, Universitaire de Poitiers, Poitiers, France;
4. 4III Med Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Heidelberg, Germany;
5. 5Hematology Research Unit, Biomedicum Helsinki, Helsinki University Central Hospital, Helsinki, Finland;
6. 6Vrije Universiteit Medical Center, Amsterdam, The Netherlands; and
7. 7Akademiska Sjukhuset, Uppsala, Sweden


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Abstract

The outcome of chronic myeloid leukemia (CML) has been profoundly changed by the introduction of tyrosine kinase inhibitors into therapy, but the prognosis of patients with CML is still evaluated using prognostic scores developed in the chemotherapy and interferon era. The present work describes a new prognostic score that is superior to the Sokal and Euro scores both in its prognostic ability and in its simplicity. The predictive power of the score was developed and tested on a group of patients selected from a registry of 2060 patients enrolled in studies of first-line treatment with imatinib-based regimes. The EUTOS score using the percentage of basophils and spleen size best discriminated between high-risk and low-risk groups of patients, with a positive predictive value of not reaching a CCgR of 34%. Five-year progression-free survival was significantly better in the low- than in the high-risk group (90% vs 82%, P = .006). These results were confirmed in the validation sample. The score can be used to identify CML patients with significantly lower probabilities of responding to therapy and survival, thus alerting physicians to those patients who require closer observation and early intervention.

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