The EUTOS prognostic score: review and validation in 1288 patients with CML treated frontline with imatinib

Abstract

The introduction of tyrosine kinase inhibitors (TKI) in the treatment of Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) has revolutionized the outcome, but the prognosis of the disease is still based on prognostic systems that were developed in the era of conventional chemotherapy and interferon (IFN)-alfa. A new prognostic score including only two variables, spleen size and basophils, was developed for the prediction of complete cytogenetic response (CCyR) and progression-free survival (PFS). The score was based on a large series of patients who were enrolled in prospective multicenter studies of first-line imatinib treatment. The prognostic value of the EUTOS (European Treatment and Outcome Study for CML) score has now been tested in an independent, multicenter, multinational series of 1288 patients who were treated first-line with imatinib outside prospective studies. It was found that also in these patients, the EUTOS prognostic score was predictive for CCyR, PFS and overall survival (OS). In addition, the prognostic value of the score was reported to be significant in seven of the eight other independent studies of almost 2000 patients that were performed in Europe, the Americas and Asia. The EUTOS risk score is a valid tool for the prediction of the therapeutic effects of TKI, particularly imatinib.

Performance of Sokal and Eutos Scores for Predicting Cytogenetic and Molecular Response in Newly Diagnosed Chronic Myeloid Leukemia-Chronic Phase Patients on Imatinib

“…[11][12][13] Average age of the population was 37.93 years. Mean spleen size was 10.2 cm which was grossly larger than what has been observed by Hoffman et al [14] This can be attributed to the lack of awareness in India about the disease amongst the patients and the basic healthcare personnel. Hence patients present usually in the late chronic phase.…”

“…Pagnano et al [16] have demonstrated a high CCyR of 83 % in similar subset of patients. But the difference among high and low risk group in achieving CCyR was statistically significant like that of Hoffman et al [14]. However, among Sokal risk group, the difference was not statistically significant.…”

Prognostic scores for patients with chronic myeloid leukemia under particular consideration of competing causes of death

“…Complete cytogenetic remission (0 % Ph + marrow cell metaphases; CCyR) after 18 months of therapy was chosen as the primary outcome. The abilities of the EUTOS score to discriminate two risk groups with significantly different CCyR probabilities at 18 months and with significantly different progression-free survival probabilities over time were confirmed by an independent validation based on 616 and 1,190 patients, respectively [12].…”

Chronic myeloid leukemia: reminiscences and dreams

“…In 2011, a simpler and TKI-specific score, the European Treatment and Outcome Study (EUTOS), was proposed but requires further confirmation before it can be widely used. 66 More recently, the response to TKIs at a given time point, disease risk and stage, BCR-ABL1 genotype, the presence of comorbidities, financial aspects and local monitoring capabilities are all being increasingly used to personalize treatment. 67 …”