The EUTOS score identifies chronic myeloid leukeamia patients with poor prognosis treated with imatinib first or second line

The Sokal and Hasford scores were developed in the chemotherapy and interferon era and are widely used as prognostic indicators in patients with chronic myeloid leukemia (CML). Recently, a new European Treatment and Outcome Study (EUTOS) scoring system was developed. We performed a multicenter retrospective study to validate the effectiveness of each of the three scoring systems. The study cohort included 145 patients diagnosed with CML in chronic phase who were treated with imatinib. In the EUTOS low- and high-risk groups, the cumulative incidence of complete cytogenetic response (CCyR) at 18 months was 86.9% and 87.5% (P = 0.797) and the 5-year overall survival rate was 92.6% and 93.3% (P = 0.871), respectively. The cumulative incidence of CCyR at 12 months, 5-year event-free survival and 5-year progression-free survival were not predicted using the EUTOS scoring system. However, there were significant differences in both the Sokal score and Hasford score risk groups. In our retrospective validation study, the EUTOS score did not predict the prognosis of patients with CML in chronic phase treated with imatinib.

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“…After the development of the EUTOS score, several studies evaluated its clinical significance and reported both negative and positive findings.…”

Section: Discussionmentioning

confidence: 99%

European Treatment and Outcome Study score does not predict imatinib treatment response and outcome in chronic myeloid leukemia patients

et al. 2014

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“…Since the first EUTOS report, 46 the prognostic value of the new score was tested in at least eight independent studies, involving more than 1800 patients treated first-line with imatinib at different doses (400 or 6-800 mg/day), [47][48][49][50][51][52][53] with imatinib 400 mg/day in combination with IFN-a or low-dose arabinosyl cytosine, 54 and also with second-generation TKIs. 53,55 These patients were recruited or registered in prospective or retrospective, singlecenter or multicenter studies in Europe, the Americas and Asia.…”

Section: Discussionmentioning

confidence: 99%

“…It is well recognized that the outcome can be predicted even better once the early response to a given treatment becomes evaluable, 7,8,[12][13][14]58,59 but a baseline assessment of Table 3. The EUTOS risk score was tested for prognosis in eight independent studies with a total of 1801 newly diagnosed patients in Europe, 47,48,52,55 the Americas, 49,53 and Asia 50,51 Marin et al 47 Jabbour et al 53 Breccia et al 48 Castagnetti et al 55 Pagnano et al 49 Tribelli et al 52 Than Abbreviations: AP, accelerated phase; BP, blastic phase; CCyR, cytogenetic response; EUTOS, European Treatment and Outcome Study for CML; MMR, major molecular response; OS, overall survival; PFS, progression-free survival; TKI, tyrosine kinase inhibitor. First-line treatment was imatinib, dose not reported in three studies; 47,48,50 Imatinib 400 mg/day; 51,52 Imatinib 400 mg/day (91%) and 800 mg/day (9%); 49 Imatinib 400 mg/day (15%) or 800 mg/day (45%), or dasatinib (19%), or Nilotinib (21%); 53 Nilotinib 800 mg/day.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2013

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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.

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“…In detail, Sokal and Hasford scores failed to differentiate CCyR rates between low-risk and intermediate-risk patients and the discrimination was significant only for CCyR rates at 18 months for high-risk patients [3] although both were successfully used to differentiate all risk patients treated with imatinib according to 5-year overall survival [10]. However, the usefulness of the EUTOS score in predicting survival and outcome in patients with early chronic phase CML treated with TKI was questioned [10, 11], although in other studies EUTOS score was reported to be potent in identifying patients with poor prognosis treated with imatinib (first or second line) or predicting long-term outcome [12–15]. In the TKI era none of available scores is reported to be useful in predicting molecular response.…”

Section: Introductionmentioning

confidence: 99%

The Hasford Score May Predict Molecular Response in Chronic Myeloid Leukemia Patients: A Single Institution Experience

et al. 2016

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The Sokal, Hasford, and EUTOS scores were established in different treatment eras of chronic myeloid leukemia (CML). None of them was reported to predict molecular response. In this single center study we tried to reevaluate the usefulness of three main scores in TKI era. The study group included 88 CML patients in first chronic phase treated initially with standard imatinib dose. All of them achieved major molecular response (MMR) in time points defined by European LeukemiaNet (ELN). 42 patients lost MMR in a median time of 47 months and we found a significant difference in MMR maintenance between intermediate-risk (IR) and low-risk (LR) patients assessed by Hasford score. All 42 patients were switched to second-generation TKI (2G-TKI) treatment. At 18 months of 2G-TKI therapy we have still found a significant difference in BCR-ABL transcript levels and MMR rate between IR and LR groups. We did not find any of the described differences discriminating patients by Sokal or EUTOS score. In this retrospective single center analysis we found Hasford score to be useful in predicting molecular response in first chronic phase of CML patients.

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The EUTOS score identifies chronic myeloid leukeamia patients with poor prognosis treated with imatinib first or second line

Cited by 19 publications

References 4 publications

European Treatment and Outcome Study score does not predict imatinib treatment response and outcome in chronic myeloid leukemia patients

European Treatment and Outcome Study score does not predict imatinib treatment response and outcome in chronic myeloid leukemia patients

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

The Hasford Score May Predict Molecular Response in Chronic Myeloid Leukemia Patients: A Single Institution Experience

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