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Chronic myelogenous leukemia

Validation of the EUTOS long-term survival score in a recent independent cohort of “real world” CML patients

Leukemia volume 32, pages 2299–2303 (2018)Cite this article

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Prognostic risk scores are used to predict survival at diagnosis in patients with chronic myeloid leukemia (CML) presenting in chronic phase. Until recently, risk stratification of CML patients was based on scores from the pre-imatinib era developed to predict overall survival probability. The Sokal risk score was published in 1984 and is based on outcome of patients treated with busulfan or splenectomy in combination with intensive chemotherapy [1]. The Hasford risk score, also known as the EURO score, was established in 1998 using data from CML patients receiving interferon-α therapy [2]. After the introduction of imatinib, the EUTOS risk score was established in 2011 to predict the chance of achieving complete cytogenetic response (CCyR) at 18 months, as a proxy for survival [3].

The life expectancy of CML patients is currently approaching the life expectancy of the general population [4, 5]. Since the major causes of death of CML patients are no longer CML-related, the need for baseline risk prediction has shifted from overall survival towards disease-specific mortality. In 2016, the EUTOS long-term survival (ELTS) score was introduced to predict the risk of dying of CML. It was developed using data from chronic phase CML patients diagnosed between 2002 and 2006 treated with imatinib [6]. In the current study, we further evaluated the ELTS score as predictor for “death due to CML” in a recent population-based cohort of CML patients treated upfront with imatinib or a second generation TKI (2GTKI). In addition, the predictive value for major molecular response (MMR) and overall survival were tested. The ELTS score was compared to Sokal, Hasford and EUTOS scores for all three endpoints.

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Acknowledgements

We thank Peter Huijgens, currently chairman of the Netherlands Comprehensive Cancer Organisation (IKNL) for initiating the Pharos registry. We thank Tom Wiggers, Wencke de Jager, Sanne Nijssen, and Jolie Cheung for entering patient data in the Pharos database. We thank Marianne van der Mark from the IKNL for retrieving survival data from the Netherlands Cancer Registry. We thank all the hospitals and molecular labs in the Netherlands who participated in the Pharos and Hemobase registries. We thank all Swedish hematologists who have carefully reported CML patients to the CML Registry, in particular the regional coordinators of the Swedish CML registry working group (Berit Markevärn, Ulla Olsson-Strömberg, Leif Stenke, Arta Dreimani, Hans Wadenvik, and Johan Richter). We also appreciate the work of data managers at the respective RCCs.

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Authors and Affiliations

  1. Department of Internal Medicine/Hematology, Albert Schweitzer Hospital, Dordrecht, The Netherlands

    Inge G. P. Geelen & Peter E. Westerweel

  2. Regional Cancer Centre, Uppsala-Örebro, Sweden

    Fredrik Sandin

  3. Department of Internal Medicine, Diakonessenhuis, Utrecht, The Netherlands

    Noortje Thielen

  4. Department of Hematology, VU University Medical Center, Amsterdam, The Netherlands

    Noortje Thielen & Jeroen J. W. M. Janssen

  5. Department of Hematology, Medical Center Leeuwarden, Leeuwarden, The Netherlands

    Mels Hoogendoorn

  6. Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands

    Otto Visser

  7. Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands

    Jan J. Cornelissen

  8. Department of Medical Science and Division of Hematology, University Hospital, Uppsala, Sweden

    Martin Hoglund

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  1. Inge G. P. Geelen
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Correspondence to Peter E. Westerweel.

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Geelen, I.G.P., Sandin, F., Thielen, N. et al. Validation of the EUTOS long-term survival score in a recent independent cohort of “real world” CML patients. Leukemia 32, 2299–2303 (2018). https://doi.org/10.1038/s41375-018-0136-7

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