The predictive value of the Sokal and Hasford scoring systems in chronic myeloid leukaemia in the imatinib era

Abstract

<p class="a"><strong>Objectives:</strong> Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder characterized by the presence of Philadelphia chromosome (Ph) or BCR-ABL1 chimeric gene; which codes for an abnormal tyrosine kinase responsible for the malignant proliferation of myeloid cells. Imatinib mesylate, a selective inhibitor of this kinase, is the first choice of therapy in patients with CML. The study aimed to determine the effect of imatinib on the survival of different risk groups based on the Sokal and Hasford scoring systems.<br /> <strong>Methods:</strong> Between August 2003 and December 2009, 134 patients <span>[</span>83 males <span>(</span>62%<span>)</span>, 51 females <span>(</span>38%)<span>]</span> who came in first chronic phase (CP1) were recruited. Median age was 36 years (range, 13 <span>-</span> 75). Patients were followed up with monthly complete blood counts. Karyotyping and chemistries were done at 6 and 12 months into therapy and then yearly. Overall survival (OS), progression-free survival (PFS) and frequency of complete cytogenetic remission (CCR) were evaluated. Survival studies were analyzed using the Kaplan- Meier technique and<em> </em><em><span>P</span></em>-value < 0.05 was considered significant.<br /> <strong>Results:</strong> OS was 99% and 94%, while PFS was 95% and 83%, at one and two years respectively. Both the Sokal and Hasford risk groups predicted significantly better PFS for low- and intermediate-risk patients (<em>P</em> = 0.012 and <em>P</em> = 0.0001 respectively). However, neither of the scores was predictive for differences in OS or CCR.<br /> <strong>Conclusions:</strong> These results suggests that the Sokal and Hasford scoring systems are inadequate in predicting OS and CCR of CML patients in CP1 managed on imatinib, as compared to their usefulness before the imatinib era.</p

Complete Molecular Response in Chronic Myeloid Leukemia After Six Months of Imatinib: A Single Center Experience

“…These are comparable to a Pakistani study by Usman et al which quotes 3.7%, 27.4%, and 67.7% respectively [12]. However the pattern reported by a study in Nigeria is different compared to the present study results (LR-40.3%, IR-33.6%, and HR-26.1%) [13].…”

Risk Stratification of Chronic Myeloid Leukemia According to Different Prognostic Scores

“…Nonetheless, this study too shows that more patients are placed in the high-risk category when using the Sokal score (34%), than when using the Hasford score (18%) [9]. The study by Oyekunle AA et al in Nigeria also reported a higher percentage of patients falling under the high-risk category when categorized by the Sokal Score than when categorized by Hasford Score [10]. The difference is, however, smaller than that found in the present study (Sokal: LR-40.3%, IR-33.6% and HR-26.1%, Hasford: LR-53.7%, IR-36.6%, and HR-9.7%).…”

Prognostic and predictive implications of Sokal, Euro and EUTOS scores in chronic myeloid leukaemia in the imatinib era—experience from a tertiary oncology centre in Southern India

“…While Sokal score and Euro score could not significantly differentiate between low and intermediate risk groups when predicting PFS and OS, they could still significantly differentiate high risk group from low/intermediate risk group. A study in the Nigerian population done by Oyekunle and colleagues also suggested that predictive efficacy for PFS remained poor for Sokal score between the low and intermediate risk groups, however, it could predict difference better between low + intermediate versus high risk groups [32]. Another study from China on the other hand had the limitation of inability to differentiate low and intermediate risk groups reflected in prediction of OS, not PFS [33].…”