Validation of the EUTOS long-term survival score in a recent independent cohort of “real world” CML patients

Geelen, Inge G.P.; Sandin, Fredrik; Thielen, Noortje; Janssen, Jeroen; Hoogendoorn, Mels; Visser, Otto; Cornelissen, Jan J.; Höglund, Martin; Westerweel, Peter E.

doi:10.1038/s41375-018-0136-7

Cited by 22 publications

(21 citation statements)

References 10 publications

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“…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. Most notably, the ELTS score outperformed the previously established Sokal, Hasford and EUTOS scores without statistical difference among different risk groups.…”

Section: Discussioncontrasting

confidence: 45%

“…Few studies have validated the effectiveness of the ELTS score in clinical trials or in real-life setting. 17,18,21 Our study strongly provided positive evidence to support that the ELTS score is a significant risk stratification measure for CML-CP patients treated with imatinib. However, there are certain limitations in our real-world study.…”

Section: Discussionmentioning

confidence: 53%

“…9,10,16 In our present cohort of 479 adult CML-CP patients treated with imatinib, the ELTS score identified a similar proportion of high-risk patients to the Hasford and EUTOS scores, but obviously lower proportion than the Sokal score, while the ratios of patients allocated to low-risk (49.8%), intermediate-risk (36.4%) and high-risk (13.9%) groups were consistent with previously published reports. 11,16,18,21 We observed the rate of cytogenetic remissions and survival time, as the regular assessment indicators reported in the original researches. For CCyR, over half of the patients could achieve cytogenetic remission within 18 months.…”

Section: Discussionmentioning

confidence: 99%

“…16 Recently, the new ELTS score has been validated in Europe to further clarify the clinical significance. [16][17][18] However, both clinical trials and real-word studies with Asian populations remain deficient, especially Chinese populations. Therefore, we performed a retrospective study to validate the predictive ability of the ELTS scoring system with Chinese CML-CP patients.…”

Section: Introductionmentioning

confidence: 99%

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

Yang¹,

Bai²,

Shi³

et al. 2020

CMAR

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These authors contributed equally to this workPurpose: To validate the clinical efficacy of the recently developed EUTOS long-term survival (ELTS) score in a real-world setting. Patients and Methods: A total of 479 chronic myeloid leukemia (CML) patients treated with frontline imatinib between January 2010 and December 2017 were enrolled in this retrospective study. The ELTS score was evaluated on the end-points including complete cytogenetic response (CCyR), progression-free survival (PFS), overall survival (OS) and CML-related death, and the efficiency of the ELTS score was further compared with the historical Sokal, Hasford, EUTOS scores. Results: With a median follow-up of 69 months (range, 9-112 months), 462 evaluable patients were stratified into the ELTS low-risk (n = 230), ELTS intermediate-risk (n = 168) and ELTS high-risk (n = 64) groups. For the regular assessment indicators like CCyR, PFS and OS, the ELTS scoring system could effectively identify the corresponding risk groups, similarly with the results provided by previous scoring systems. With respect to the CML-related death, the ELTS score could accurately identify a highrisk group with a significantly higher risk of dying of CML, and the 5-year cumulative incidence occurred in the ELTS high-, intermediate-, and low-risk groups was 11% (95% CI: 3-19%), 5% (95% CI: 1-9%) and 2% (95% CI: 0-4%), respectively. Most notably, the ELTS score outperformed the Sokal, Hasford and EUTOS scores without statistical difference among different risk groups. Conclusion: The ELTS score could effectively predict the prognosis of imatinib-treated CML patients in real-life settings.

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Section: Discussioncontrasting

confidence: 45%

Section: Discussionmentioning

confidence: 53%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Yang¹,

Bai²,

Shi³

et al. 2020

CMAR

View full text Add to dashboard Cite

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“…These risk scores were designed to evaluate differences in survival [21,22] or response [23]. Since most patients now die from causes other than leukemia while still in remission, a fourth risk score has been developed to predict the probability of dying from CML (leukemia-related death, LRD): the new EUTOS Long Term Survival (ELTS) score [24][25][26]. The ELTS score, based on TKI-treated patients, uses the same simple hematologic data, spleen size, and age as Sokal.…”

Section: Baseline Prognostic Factorsmentioning

confidence: 99%

European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia

et al. 2020

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The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available firstline). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

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The EUTOS long‐term survival score predicts disease‐specific mortality and molecular responses among patients with chronic myeloid leukemia in a practice‐based cohort

et al. 2020

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The European Treatment and Outcome Study (EUTOS) long‐term survival (ELTS) score predicts disease‐specific death in patients with chronic myeloid leukemia (CML) being treated with imatinib during the chronic phase (CP) of the disease. However, it is unclear whether the ELTS score predicts CML‐related events or treatment responses. This study evaluated the predictive value of the ELTS score regarding prognosis and treatment response in patients with CML‐CP. Clinical data were retrospectively obtained from patients enrolled in the CML Cooperative Study Group (CML‐CSG), which included patients diagnosed with CML‐CP from April 2001 to January 2016, and treated with any tyrosine kinase inhibitor (TKI) as first‐line therapy. Among 342 eligible patients, the ELTS scores indicated low‐, intermediate‐, and high‐risk in 74%, 21%, and 5% of patients, respectively. Patients with high ELTS scores had significantly higher disease‐specific mortality and worse event‐free survival, progression‐free survival, and overall survival. Among four risk scores, including the Sokal, Hasford, EUTOS, and ELTS scores, risk stratification by the ELTS score had the highest predictive value in assessing patient prognosis, and also in treatment responses. In fact, the EUTOS and ELTS scores were able to predict the major molecular response within 12 months. Most importantly, the ELTS score was the only scoring system that predicted deep molecular response at any time, regardless of risk level (65.0%, 43.7%, and 23.5% in low‐, intermediate‐, and high‐risk groups, respectively). Compared to other risk scores, the ELTS score was the most sensitive risk classification tool for the four endpoints of interest in this study, as well as molecular responses in patients with CML‐CP.

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Validation of the EUTOS long-term survival score in a recent independent cohort of “real world” CML patients

Cited by 22 publications

References 10 publications

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

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

European LeukemiaNet 2020 recommendations for treating chronic myeloid leukemia

The EUTOS long‐term survival score predicts disease‐specific mortality and molecular responses among patients with chronic myeloid leukemia in a practice‐based cohort

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