Prognostic factors in chronic myeloid leukemia: can we gain more from combination?
Authors:
Z. Čermáková 1; J. Fürstová 2; T. Fürst 3; I. Marešová 4; I. Skoumalová 4; P. Rohoň 4; K. Indrák 4; T. Papajík 4; E. Faber 4
Authors‘ workplace:
Onkologická klinika FN Ostrava
1; 1. LF UK Praha
2; PřF UP v Olomouci
3; Hemato-onkologická klinika FN a LF UP v Olomouci
4
Published in:
Transfuze Hematol. dnes,22, 2016, No. 1, p. 6-13.
Category:
Comprehensive Reports, Original Papers, Case Reports
Overview
There are several prognostic scoring systems that are used for estimation of prognosis of patients with chronic myeloid leukaemia (CML) after the treatment with tyrosine kinase inhibitors (TKI) (EUTOS, Sokal and Hasford score). Individual patients may be allocated to different prognostic groups according various scores. It may be possible to improve the prognostication by the combination of these indices. The value of the new score was assessed in the group of 193 CML patients treated at Department of Haemato-Oncology in Olomouc between 1989 and 2013. Data collection and control was performed retrospectively. Method according Kaplan and Meier in combination with log-rank test was used for survival estimations. The group consisted of 77 females (39.9%) and 116 males (60.1%) at age 17–88 (median 54). Follow-up of the patients ranged from 3.6 to 296.6 months (median = 89.1). Seventy two (37.3%) patients were pretreated with interferon alfa for median of 9.33 months. Statistical analysis has confirmed good prognostic value of the Sokal and Hasford score for estimation of overall survival (OS) and progression-free survival (PFS). EUTOS score has not discriminated the good and poor risk patients with statistical significance in OS, for PFS it had the poorest performance. In order to count the new risk score the risk scores according to the Sokal and Hasford system were converted to the points (1 point for low, 2 points for intermediate and 3 points for high risk). The summary of points varied in individual patients between 2 and 6. The new score has improved the prognostic assessment of both OS and PFS. Adding EUTOS score to the combination has not improved the prediction significantly. The new score was better than existing indices also for the prognostic assessment of the patients not pretreated with interferon. Our statistical analysis showed that with the use of the simple combination of the existing scores (Sokal and Hasford) the prognostic assessment of CML patients may be improved. The results must be validated in larger groups of CML patients.
Key words:
chronic myeloid leukaemia – Hasford score – Sokal score – EUTOS score – prognosis – tyrosine kinase inhibitors
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