Prognostic and predictive implications of Sokal scoring system in newly diagnosed Chronic Myeloid Leukemia patients

Abstract

Objective: To assess the predictive utility of the Sokal scoring system for determining disease prognosis in newly diagnosed patients with chronic myeloid leukemia (CML). Methodology: This comparative cross-sectional study was conducted at the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from September 2021 to September 2022. The study included all newly diagnosed Philadelphia-positive chronic myeloid leukemia (CML) patients. Patients with CML in the accelerated and blast phases, as well as those with atypical CML, were excluded. Gender was considered as a qualitative variable of interest, while platelet count, spleen size, age, and percentage of myeloblasts in the peripheral blood were the quantitative variables of interest. These variables were documented using preformed data sheets, and the prognostic class of each patient was recorded. Follow-up assessments were conducted after 3 months for patients who received the same tyrosine kinase inhibitor (TKI) therapy to avoid bias. Results: A total of 62 patients were included in the study, with a mean age of 46±5 years. According to the Sokal scoring system, 20 (32%) of 62 patients were classified as low-risk, 34 (54.8%) as intermediate-risk, and 8 (12.9%) as high-risk. Conclusion: The routine implication of traditional prognostic scoring systems, such as the Sokal score, is beneficial for stratifying CML patients into different risk groups due to its cost-effectiveness. Regression in Sokal score grades was observed after 3 months of TKI therapy.