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

Abstract

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.

<p>Validation of the EUTOS Long-Term Survival Score in Chinese Chronic Myeloid Leukemia Patients Treated with Imatinib: A Multicenter Real-World Study</p>

“…The whole data compared favorably with the results in prior reports. 11,14,[21][22][23][24][25] The cumulative 5-year CML-related death rate reported in our research was 11% in the ELTS high-risk group, 5% in the ELTS intermediate-risk group, and 2% in the ELTS lowrisk group. The data demonstrated there was higher incidence compared with the results reported in the confirmatory study by Geelen et al 18 Although the incidence was not exactly consistent, the ELTS score still distinguished the high-risk group with a significantly higher rate of disease-related death than the other risk groups.…”

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

“…EUTOS score was low for 90% and high for 10% in this study. The Japanese study also had lower proportionate cases of high risk with 18.6%, 8.9%, and 11% cases with Sokal, Euro, and EUTOS high risk [2]. …”

“…Various other studies comparing EUTOS score with the previous scores are summarised in Table 5. The two studies from UK and Japan showed inadequate efficacy of EUTOS as a prognostic marker [34, 2]. These studies, however, had a relatively small number of cases classified as EUTOS high risk group, being 31(10%) and 16 (11%) respectively in the two studies.…”

“…Amongst the many scores available, which one will best predict response to current imatinib therapy and prognosticate survival outcome still remains debatable with very limited data available from the Asian population [2–4]. We here try to assess the most widely used prognostic risk models including Sokal relative risk score, Euro relative risk score, and EUTOS (European Treatment and Outcome Study) score in a large cohort of Indian patients and compare their efficacy as a predictive and prognostic tool in the imatinib era.…”

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

“…Originally the EUTOS score was successful to predict probability of complete cytogenetic response (CCyR) within 18 months of imatinib initiation and progression-free survival (PFS) for patients receiving imatinib [3]. 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].…”