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Sokal Scoring

Started by hannibellemo , May 22 2017 04:55 PM

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3 replies to this topic

#1 hannibellemo

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728 posts

LocationNorth Central Iowa

Posted 22 May 2017 - 04:55 PM

Hi, all! I'm just curious...with the advent of TKIs just how important is the various scoring now as it used to be? I follow the ICMLF clinical case discussion forum and just about every doc mentions a score (usually Sokal) when introducing their case.

Pat

"You can't change the direction of the wind but you can adjust your sails."

DX 12/08; Gleevec 400mg; liver toxicity; Sprycel 100mg.; CCyR 4/10; MMR 8/10; Pleural Effusion 2/12; Sprycel 50mg. Maintaining MMR; 2/15 PCRU; 8/16 drifting in and out of undetected like a wave meeting the shore. Retired 12/23/2016! 18 months of PCRU, most recent at Mayo on 7/25/17 was negative at their new sensitivity reporting of 0.003.<p>

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#2 Gail's

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634 posts

Posted 22 May 2017 - 06:53 PM

I'm not really sure why it's used since I believe the Sokal was developed prior to TKIs, but my doctor included it in my chart.

Diagnosed 1/15/15
FISH 92%
BMB 9:22 translocation
1/19/15 began 400 mg gleevec
1/22/15 bcr 37.2 IS
2/6/15 bcr 12.5 IS
3/26/15 bcr 10.3 IS
6/29/15 bcr 7.5 IS
9/24/15 bcr 0.8 IS
1/4/16 bcr 0.3 IS
Started 100 mg dasatinib, mutation analysis negative
4/20/16 bcr 0.03 IS
8/8/16 bcr 0.007 IS
12/6/16 bcr 0.002 IS
Lowered dasatinib to 70 mg
4/10/17 bcr 0.001 IS
Lowered dasatinib to 50 mg
7/5/17 bcr 0.004 IS
8/10/17 bcr 0.001. Stopped TKI in prep for September surgery.
9/10/17 bcr 0.006
10/10/17 bcr 0.088

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#3 gerry

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Posted 23 May 2017 - 12:04 AM

They still talk about it in regard to cessation.

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#4 Trey

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LocationSan Antonio, Texas

Posted 23 May 2017 - 05:04 PM

Overall I think it is outdated in the TKI era. To me, the most important negative factor in the Sokal and Hasford scoring are elevated blast count (esp. peripheral blood). I think spleen size is not very useful. Platelet count is variable since some have very elevated PLT at diagnosis while others who are in advanced stages do not. Age is only useful over maybe 70 yrs old. I think high basophils is somewhat useful as a predictor but is not in the Sokal.

https://www.mdcalc.com/sokal-index-cml

Edited by Trey, 23 May 2017 - 05:07 PM.