3 replies to this topic

[Skittles]

Does anyone know more about this scoring system for risk factors associated with CML?   I tried to copy & paste a link to this from Bloodjounal.hematologylibray.org but it would not paste here.  I know Trey will have an answer and perhaps others as well.  It appears that the sokal score and euro score are not as accurate these days in light of TKI's.  I was not able to to view much about it other than the fact that age is not as important as once thought but would like to know what else matters or doesn't according to this system.  Thanks guys!  Skittles

[Trey]

Personally, I don't put much stock into any of the CML risk scoring calculators in this age of TKI drugs.  TKI drugs have indeed changed the equation, and since the second line TKIs were approved, it changed even more.

The EUTOS score for CML is very simplistic, since it only measures basophils and spleen size.  How many of us know what our spleen size was at diagnosis, before starting any medication?  Although it seems harmless enough, not using blast percentages seems odd, so I would not trust it.

The SOKOL score for CML is useless in my book.  It was outdated in the age of interferon alpha, let alone TKI drugs.  I used the Sokol calculator and the result came back: "The risk is High and expected median survival 35 months".  Bovine sharts.  I reached PCRU in just over 6 months mostly on 400mg Gleevec (a couple months on 600mg) and have been continuously PCRU for over 5 years now.  HIgh risk my posterior orifice.

There is also a Hasford score (a lot like SOKOL with some minor tweaking) that was a little better during interferon alpha days, but has not been shown reliable after TKI drugs were introduced.

I would not use any of the CML risk calculators to make treatment decisions for CML.  The best indicator is to start taking TKI drugs and see how they work.  If one fails, use another.  The exception might be high blast count at diagnosis, but even then one needs to weigh the risks inherent in the alternatives (BMT).

[Trey]

I found a study that showed how often these CML risk scoring systems are accurate:

Euro: 34%

SOKAL: 25%

Hasford: 26%

I would believe a sharting monkey with a dart board before I would believe of any of these.

[Marnie]

Trey, you sure do provide interesting visuals.