Open Access
CC BY-NC-ND 4.0 · South Asian J Cancer 2018; 07(04): 258-262
DOI: 10.4103/sajc.sajc_244_17
ORIGINAL ARTICLE: Hematolymphoid Malignancies

Comparative analysis of the Sokal, Euro and European Treatment and Outcome Study score in prognostication of Indian chronic myeloid leukemia-chronic phase patients on imatinib

Autor*innen

  • Sunita Chhikara

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Sudha Sazawal

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Kanwaljeet Singh

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Rekha Chaubey

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Haraprasad Pati

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Seema Tyagi

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Manoranjan Mahapatra

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India
  • Renu Saxena

    Department of Hematology, All India Institute of Medical Sciences, New Delhi, India

Financial support and sponsorship The first author Sunita Chhikara acknowledges the Indian Council of Medical Research, New Delhi, for the research fellowship.

Abstract

Introduction: The ultimate goal for CML management is risk stratification of the patients to design the appropriate treatment approach. The Sokal, Euro and EUTOS risk scores were established to prognosticate the patients on therapy. Aim: To perform a comparative assessment of the Sokal, Euro and EUTOS prognostic score in Indian CML-CP patients on imatinib. Methods: This is a retrospective study performed in 260 Ph+ CML-CP patients who were administered oral imatinib (400 mg/day). Results: 166/260 were males and 94/260 were females (M: F::1.6:1) with median age 35 years (range 20-70). 92 (35.38%), 125 (48.07%) and 43 (16.5%) patients were divided into low, intermediate and high risk Sokal score respectively. 102 (39.23%), 106 (40.76%) and 52 (20%) patients were discriminated into low, intermediate and high risk Euro score respectively. 210 (80.7%) and 50 (19.2%) patients were divided into low and high risk EUTOS score. Cumulative incidence of MMR for low, intermediate and high-risk Sokal score was 87%, 76% and 84% respectively (P = 0.016). Incidence of MMR in low, intermediate and high-risk Euro score was 93%, 85% and 68% respectively (P = 0.001). Incidence of MMR was 80 % and 81% for low and high risk EUTOS score (P = 0.764). Both EFS and OS are significantly correlated with Sokal score (P = 0.004, P = 0.007) and Euro score (P = 0.009, P = 0.001) but not with EUTOS score (P = 0.581, P = 0.927). Conclusion: The present study highlights the significant prognostic role of Sokal and Euro score in predicting the treatment outcome of the CML- CP patients on imatinib.



Publikationsverlauf

Artikel online veröffentlicht:
21. Dezember 2020

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  • References

  • 1 Trask PC, Mitra D, Iyer S, Candrilli SD, Kaye JA. Patterns and prognostic indicators of response to CML treatment in a multi-country medical record review study. Int J Hematol 2012;95:535-44.
  • 2 Verbeek W, König H, Boehm J, Kohl D, Lange C, Heuer T, et al. Continuous complete hematological and cytogenetic remission with molecular minimal residual disease 9 years after discontinuation of interferon-alpha in a patient with Philadelphia chromosome-positive chronic myeloid leukemia. Acta Haematol 2006;115:109-12.
  • 3 Faderl S, Talpaz M, Estrov Z, O'Brien S, Kurzrock R, Kantarjian HM, et al. The biology of chronic myeloid leukemia. N Engl J Med 1999;341:164-72.
  • 4 Cwynarski K, Roberts IA, Iacobelli S, van Biezen A, Brand R, Devergie A, et al. Stem cell transplantation for chronic myeloid leukemia in children. Blood 2003;102:1224-31.
  • 5 Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE, et al. Prognostic discrimination in “good-risk” chronic granulocytic leukemia. Blood 1984;63:789-99.
  • 6 Hasford J, Pfirrmann M, Hehlmann R, Allan NC, Baccarani M, Kluin-Nelemans JC, et al. Anew prognostic score for survival of patients with chronic myeloid leukemia treated with interferon Alfa. Writing committee for the collaborative CML prognostic factors project group. J Natl Cancer Inst 1998;90:850-8.
  • 7 Hasford J, Baccarani M, Hoffmann V, Guilhot J, Saussele S, Rosti G, et al. Predicting complete cytogenetic response and subsequent progression-free survival in 2060 patients with CML on imatinib treatment: The EUTOS score. Blood 2011;118:686-92.
  • 8 Hu B, Savani BN. Impact of risk score calculations in choosing front-line tyrosine kinase inhibitors for patients with newly diagnosed chronic myeloid leukemia in the chronic phase. Eur J Haematol 2014;93:179-86.
  • 9 Yahng SA, Jang EJ, Choi SY, Lee SE, Kim SH, Kim DW, et al. Prognostic discrimination for early chronic phase chronic myeloid leukemia in imatinib era: Comparison of Sokal, Euro, and EUTOS scores in Korean population. Int J Hematol 2014;100:132-40.
  • 10 Tao Z, Liu B, Zhao Y, Wang Y, Zhang R, Han M, et al. EUTOS score predicts survival and cytogenetic response in patients with chronic phase chronic myeloid leukemia treated with first-line imatinib. Leuk Res 2014;38:1030-5.
  • 11 Bonifacio M, Binotto G, Calistri E, Maino E, Tiribelli M; Gruppo Triveneto LMC. EUTOS score predicts early optimal response to imatinib according to the revised 2013 ELN recommendations. Ann Hematol 2014;93:163-4.
  • 12 Hoffmann V, Baccarani M, Hasford J, Guilhot J, Saussele S, Rosti G, et al. The EUTOS CML score aims to support clinical decision-making. Blood 2012;119:2966-7.
  • 13 Jabbour E, Cortes J, Nazha A, O'Brien S, Quintas-Cardama A, Pierce S, et al. 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 2012;119:4524-6.
  • 14 Yamamoto E, Fujisawa S, Hagihara M, Tanaka M, Fujimaki K, Kishimoto K, et al. European treatment and outcome study score does not predict imatinib treatment response and outcome in chronic myeloid leukemia patients. Cancer Sci 2014;105:105-9.
  • 15 Marin D, Ibrahim AR, Goldman JM. European treatment and outcome study (EUTOS) score for chronic myeloid leukemia still requires more confirmation. J Clin Oncol 2011;29:3944-5.
  • 16 Kuntegowdanahalli LC, Kanakasetty GB, Thanky AH, Dasappa L, Jacob LA, Mallekavu SB, et al. Prognostic and predictive implications of Sokal, Euro and EUTOS scores in chronic myeloid leukaemia in the imatinib era-experience from a tertiary oncology centre in southern india. Ecancermedicalscience 2016;10:679.
  • 17 Kantarjian H, Sawyers C, Hochhaus A, Guilhot F, Schiffer C, Gambacorti-Passerini C, et al. Hematologic and cytogenetic responses to imatinib mesylate in chronic myelogenous leukemia. N Engl J Med 2002;346:645-52.
  • 18 Hughes T, Deininger M, Hochhaus A, Branford S, Radich J, Kaeda J, et al. 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 2006;108:28-37.
  • 19 Kaplan GL, Meier P. Nonparametric estimation from incomplete observations J Am Stat Assoc 1958;53:457.
  • 20 Peto R, Pike MC. Conservatism of the approximation sigma (O-E)2-E in the logrank test for survival data or tumor incidence data. Biometrics 1973;29:579-84.
  • 21 Baccarani M, Cortes J, Pane F, Niederwieser D, Saglio G, Apperley J, et al. Chronic myeloid leukemia: An update of concepts and management recommendations of European leukemiaNet. J Clin Oncol 2009;27:6041-51.
  • 22 Luatti S, Castagnetti F, Marzocchi G, Baldazzi C, Gugliotta G, Iacobucci I, et al. Additional chromosomal abnormalities in Philadelphia-positive clone: Adverse prognostic influence on frontline imatinib therapy: A GIMEMA working party on CML analysis. Blood 2012;120:761-7.
  • 23 Dulucq S, Bouchet S, Turcq B, Lippert E, Etienne G, Reiffers J, et al. Multidrug resistance gene (MDR1) polymorphisms are associated with major molecular responses to standard-dose imatinib in chronic myeloid leukemia. Blood 2008;112:2024-7.
  • 24 Ng KP, Hillmer AM, Chuah CT, Juan WC, Ko TK, Teo AS, et al. Acommon BIM deletion polymorphism mediates intrinsic resistance and inferior responses to tyrosine kinase inhibitors in cancer. Nat Med 2012;18:521-8.
  • 25 de Lavallade H, Apperley JF, Khorashad JS, Milojkovic D, Reid AG, Bua M, et al. Imatinib for newly diagnosed patients with chronic myeloid leukemia: Incidence of sustained responses in an intention-to-treat analysis. J Clin Oncol 2008;26:3358-63.
  • 26 Saglio G, Kim DW, Issaragrisil S, le Coutre P, Etienne G, Lobo C, et al. Nilotinib versus imatinib for newly diagnosed chronic myeloid leukemia. N Engl J Med 2010;362:2251-9.
  • 27 Hochhaus A, O'Brien SG, Guilhot F, Druker BJ, Branford S, Foroni L, et al. Six-year follow-up of patients receiving imatinib for the first-line treatment of chronic myeloid leukemia. Leukemia 2009;23:1054-61.
  • 28 Tardieu S, Brun-Strang C, Berthaud P, Michallet M, Guilhot F, Rousselot P, et al. Management of chronic myeloid leukemia in France: A multicentered cross-sectional study on 538 patients. Pharmacoepidemiol Drug Saf 2005;14:545-53.
  • 29 Bansal S, Prabhash K, Parikh P. Chronic myeloid Leukemia data from India. Indian J Med Paediatr Oncol 2013;34:154-8.