Chronic Myeloid Leukemia Coverage from Every Angle

Comparing Prognostic Scores in Predicting Outcomes in CML

By: Kayci Reyer
Posted: Tuesday, September 1, 2020

According to research published in Leukemia, the European Treatment and Outcome Study (EUTOS) Long-Term Survival (ELTS) score is the superlative prognostic score among the four commonly used to predict survival in chronic myeloid leukemia (CML). The ELTS score outperformed the persistently popular Sokal score as well as the Euro and EUTOS scores.

“The recent recommendation of the European LeukemiaNet for preferred use of the ELTS score was supported with significant statistical evidence,” concluded Markus Pfirrmann, PhD, of Ludwig-Maximilians Universität, Munich, and colleagues.

The study sourced its patients from a CML registry established by the European LeukemiaNet, which contains data on adults enrolled between 2002 and 2006. Eligibility criteria for this study included a diagnosis of chronic-phase Philadelphia chromosome-positive, and/or BCR-ABL1–positive CML, the presence of no transcript type except B2a2 and/or B3a2, and having undergone some type of imatinib treatment in the first 6 months from diagnosis. The first step of the study focused on 2,949 patients with chronic-phase CML who had not been involved with any score development. The ELTS score returned the best discrimination of long-term survival, as demonstrated by higher hazard ratios and concordance indices.

The second step analyzed data for 5,154 patients to determine variations in the classifications of risk groups. Of those evaluated, 23% (n = 1,197) were identified at high risk using the Sokal score. However, the ELTS score found that 56% of those 1,197 patients were not at high risk, assigning them to a substantially improved long-term survival prognosis than the remaining high-risk patients. In addition to assigning more patients to the high-risk category, the Sokal score also assigned fewer patients to the low-risk category (40% vs. 60% with ELTS).

Disclosure: For full disclosures of the study authors, visit

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