A summary of the main data comparing the application of the Sokal risk score and of the new ELTS risk score to newly diagnosed CML patients
| Reference* . | No. of patients . | TKI . | Risk distribution, OS, and LRD . | Low risk . | Intermediate risk . | High risk . | |||
|---|---|---|---|---|---|---|---|---|---|
| SOKAL . | ELTS . | SOKAL . | ELTS . | SOKAL . | ELTS . | ||||
| Pfirrmann et al53 | 5154 | Imatinib | % of patients | 38 | 56 | 38 | 29 | 23 | 14 |
| 10-y OS, % | 89 | 88 | 81 | 79 | 75 | 68 | |||
| 6-y LRD, % | 3 | 2 | 4 | 5 | 8 | 12 | |||
| Castagnetti et al54 | 904 | Imatinib/ 2GTKI | % of patients | 40 | 57 | 39 | 30 | 21 | 13 |
| 8-y OS, % | 95 | 94 | 85 | 81 | 84 | 61 | |||
| 8-y LRD | 2 | 2 | 6 | 9 | 10 | 14 | |||
| Geelen et al55 | 709 | Imatinib | % of patients | 25 | 47 | 43 | 36 | 32 | 17 |
| 8-y OS, % | NR | 89 | NR | 67 | NR | 55 | |||
| 8-y LRD, % | NR | 1 | NR | 8 | NR | 5 | |||
| 244 | 2GTKI | % of patients | 27 | 49 | 41 | 35 | 32 | 16 | |
| 8-y OS, % | NR | 92 | NR | 78 | NR | 77 | |||
| 8-y LRD, % | NR | 0 | NR | 0 | NR | 6 | |||
| Reference* . | No. of patients . | TKI . | Risk distribution, OS, and LRD . | Low risk . | Intermediate risk . | High risk . | |||
|---|---|---|---|---|---|---|---|---|---|
| SOKAL . | ELTS . | SOKAL . | ELTS . | SOKAL . | ELTS . | ||||
| Pfirrmann et al53 | 5154 | Imatinib | % of patients | 38 | 56 | 38 | 29 | 23 | 14 |
| 10-y OS, % | 89 | 88 | 81 | 79 | 75 | 68 | |||
| 6-y LRD, % | 3 | 2 | 4 | 5 | 8 | 12 | |||
| Castagnetti et al54 | 904 | Imatinib/ 2GTKI | % of patients | 40 | 57 | 39 | 30 | 21 | 13 |
| 8-y OS, % | 95 | 94 | 85 | 81 | 84 | 61 | |||
| 8-y LRD | 2 | 2 | 6 | 9 | 10 | 14 | |||
| Geelen et al55 | 709 | Imatinib | % of patients | 25 | 47 | 43 | 36 | 32 | 17 |
| 8-y OS, % | NR | 89 | NR | 67 | NR | 55 | |||
| 8-y LRD, % | NR | 1 | NR | 8 | NR | 5 | |||
| 244 | 2GTKI | % of patients | 27 | 49 | 41 | 35 | 32 | 16 | |
| 8-y OS, % | NR | 92 | NR | 78 | NR | 77 | |||
| 8-y LRD, % | NR | 0 | NR | 0 | NR | 6 | |||
Sokal risk score50 ; the new ELTS risk score.53 In all 3 studies, the ELTS score identified similar proportions of patients: 55%, 57%, 47%, and 49%, low; 28%, 30%, 36%, and 35%, intermediate; 13%, 13%, 17%, and 16%, high. In all 3 studies, the proportion of high-risk patients was higher with Sokal than with ELTS. This is due to the fact that age weighs more on Sokal than on ELTS calculation because, in the era of conventional chemotherapy, the prognostic value of age was higher than it is today in the TKI era. ELTS high-risk patients have an inferior OS and a superior LRD rate, as compared with Sokal high-risk ones. The calculation of the ELTS risk score is as follows: 0.0025 × (age/10)3 + 0.0615 × spleen + 0.1052 blasts + 0.4104 × (platelet count/1000)−0.5, where age is in years, spleen in centimeters, maximum distance below costal margin, manual palpation, blasts are the percentage of blasts in blood.53 Risk score: low, ≤1.5680; intermediate, 1.5680 − ≤2.2185; high, >2.2185.
LRD, leukemia-related death; NR, not reported; OS, overall survival.
Pfirrmann et al53 (5154 patients treated with imatinib); Castagnetti et al54 (559 patients treated with imatinib, 345 pts treated with 2GTKIs, with no reported difference between imatinib and 2GTKIs), ASH 2018 (GIMEMA data); Geelen et al55 (709 patients treated with imatinib and 244 patients treated with 2GTKIs) (Dutch and Swedish registries data).