Clinical Study On Sokal, Hasford And EUTOS Prognostic Scoring Systems In The Patients With Chronic Myeloid Leukemia

Objective:To analyze the clinical characteristics, laboratory features and therapeutic methods of the newly diagnosed CML chronic phase patients from January2008to September2013in Shandong Provincial Hospital. To compare the validity of three currently used chronic myeloid leukemia (CML) scoring systems (Sokal CML prognostic scoring system, Hasford prognostic scoring system, and EUTOS prognostic scoring system) in CML patients.Methods:A retrospective study of one hundred and thirteen newly diagnosed CML chronic phase patients was aimed to analyze their clinical characteristics, laboratory features and main therapeutic methods. These patients were grouped based on three scoring systems and different therapies, and overall survival was observed and compared in different groups. Survival curves and OS rate were estimated with Kaplan-Meier and Log-rank respectively. Correlations between Sokal, Hasford, EUTOS scoring system scores were investigated by the Spearman bivariate correlation analysis. Univariate prognostic analysis and multivariate prognostic analysis were carried out by Cox regression model. Statistical Packages for the Social Sciences v19.0software was carried out for all statistical analysis. P value <0.05was considered as statistically significant.Results:Three scoring systems are effective predictors of overall survival in CML patients, and EUTOS scoring system predicts more validly. Hasford scoring system is well correlated with Sokal and EUTOS scores (r=0.792, P<0.001and r=0.624, P<0.001). The correlation between Sokal and EUTOS scores is relatively weak (r=0.508, P<0.001). Despite its marked effect in prolonging survival of CML patients, imatinib was incapable of prolonging survival in Sokal, Hasford and EUTOS high-risk group patients. From the univariate prognostic analysis of Cox regression model, therapy, percentage of peripheral blood blasts, concentration of hemoglobin, percentage of marrow blasts, spleen size, Sokal score, Hasford score and EUTOS score are associated with CML prognosis. From multivariate prognostic analysis, only therapy is an independent factor affecting survival of chronic phase CML patients.Conclusion:EUTOS prognostic scoring system may predict better than Sokal and Hasford systems in CML patients. Classification of patients based on Sokal, Hasford and EUTOS score may assist in the choice of appropriate therapy for CML.