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

Abstract

Sokal index was developed in the pre-imatinib era to predict and prognosticate the outcome of Chronic myeloid leukemia (CML) patients. In the Imatinib era, a new scoring system called EUTOS scoring system has been validated as a predictive marker in CML. The scores have shown variable correlation with complete cytogenetic response (CCyR) and major molecular response (MMR). To assess the performance of Sokal score and EUTOS score as a predictive marker for CCyR and MMR for newly diagnosed CML-CP patients treated with TKIs. 273 patients with newly diagnosed CML were included in the study. They were treated with upfront imatinib. They were followed up for a median period of 3years. Cytogenetic and Molecular response to the treatment were monitored regularly. Out of 273 patients, 174 patients (63%) were having low EUTOS score and 99 (37%) were having high EUTOS score. Patients with low, intermediate and high sokal scores were 237 (86.8%), 28 (10.3%) and 8 (2.9%) respectively. 122 patients with low EUTOS score achieved CCyR within 18months compared to 42 patients with high EUTOS score (p=0.000).113 patients with low EUTOS score achieved MMR in 18months compared to 33 patients with high EUTOS score (p=0.000). 148, 14, 2 patients with low, intermediate and high Sokal score respectively have achieved CCyR in 18months (p=0.054). 133, 11, 2 patients with low intermediate and high sokal score respectively have achieved MMR in 18months.(p=0.06). EUTOS is better than Sokal score in predicting the outcome of patients of CML treated with imatinib.