| Objective1.To investigatethe values of Sokal score,Hasford score,EUTOS score and ELTS score on the clinical efficacy in newly diagnosed CML-CP patients treated with imatinib.2.To preliminarily explore the influence of clinical baseline characteristics,Sokal score,Hasford score,EUTOS score,ELTS score and treatment response at different time points on the acquisition of deep molecular response(MR4.5)in newly diagnosed CML-CP patients.Methods1.Clinical data(sex,age,hemoglobin,platelet count,white blood cell count,percentage of peripheral blood blast cells,percentage of basophils,percentage of eosinophils,bone marrow blast count,spleen size)of 240 newly diagnosed CML-CP patients treated with imatinib was analysed in our hospital from January 2008 to December 2018.Risk stratification was assessed according to Sokal score,Hasford score,EUTOS score,and ELTS score.The relationship between Sokal score,Hasford score,EUTOS score and ELTS score and early molecular response at 3 month(3M-EMR),complete cytogenetic resonse at 6 month(6M-CCyR)and major molecular response at 12 month(12M-MMR)was evaluated.2.To perform univariate and multivariate analyses on the relationship between clinical data(sex,age,hemoglobin,platelet,peripheral blood leukocyte count,spleen size),Sokal score,Hasford score,EUTOS score,ELTS score,3-month BCR-ABL transcript level and MR4.5 in 240 newly diagnosed CML-CP patients treated with imatinib from January 2008 to December 2018 in our hospital.Results1.According to EUTOS score,48 cases(20.0%)were in the high-risk group,and 192 cases(80%)were in the low-risk group.According to Sokal score,there were 40 cases(16.7%)in the high-risk group,90 cases(37.5%)in the medium-risk group,and 110 cases(45.8%)in the low-risk group.According to Hasford score,there were 42 cases(17.5%)in the high-risk group,102 cases(42.5%)in the medium-risk group,and 96 cases(40.0%)in the low-risk group.According to the ELTS score,there were 36 cases(15.0%)in the high-risk group,85 cases(35.4%)in the medium-risk group,and 119 cases(49.6%)in the low-risk group.2.At the end of 3 months,219 patients treated with imatinib were eligible to participate in the assessment of EMR,of which 164(74.9%)received 3M-EMR;At the end of 6 months,180 patients treated with imatinib participated in the evaluation of CCyR,and 130 patients(72.2%)obtained 6M-CCyR.111 patients treated with imatinib were eligible to participate in the assessment of MMR at 12 months,and 60(54.1%)patients obtained 12M-MMR.Sokal score,Hasford score,EUTOS score and ELTS score the patients in the low risk group(low risk group + medium risk group)had better response to imatinib than the patients in the high risk group.The difference between Sokal and ELTS scores and 3M-EMR was statistically significant(P<0.05);There was statistically significant difference between EUTOS and ELTS scores and 12M-MMR(P < 0.05).There were no significant differences in Sokal score,Hasford score,EUTOS score,ELTS score and 6M-CCyR(all P > 0.05).3.The influencing factors of obtaining MR4.5 were analyzed.Univariate analysis showed that gender(female),hemoglobin(≥100g/L),platelet count(>300×109/L),white blood cell count(≤150×109/L),and spleen size were correlated with MR4.5(P < 0.5).Among the four scoring systems,the Sokal score in the low-risk group had a higher MR4.5 acquisition rate than the Sokal-score high-risk group.There was no significant difference in the relationship between Hasford score,EUTOS score,ELTS score and MR4.5(P>0.5).In addition,3M-EMR was also associated with MR4.5(P<0.001).Multivariate regression analysis showed gender,white blood cell count,platelet count,and hemoglobin as independent prognostic factors for MR4.5.The Sokal score low-risk group(HR=0.58,95% CI: 0.26-0.89,P=0.018)and 3M-EMR(HR=0.47,95% CI: 0.28-0.84,P=0.003)were independently associated with MR4.5.Compared with 3M-EMR alone predicting MR4.5,the Sokal score low-risk group combined with 3M-EMR could better predict MR4.5(HR=0.42,95% CI: 0.21-0.82,P=0.005).Conclusion1.Imatinib had a significant clinical effect on newly diagnosed CML-CP patients and patients in the low-risk group had a better response than those in the high-risk group.2.Sokal score and ELTS score could better evaluate 3M-EMR.EUTOS score and ELTS score could better evaluate 12M-MMR.Sokal score,Hasford score,EUTOS score and ELTS score showed no difference in the evaluation of 6M-CCyR.3.Gender,platelet count,white blood cell count and hemoglobin were independent factors for MR4.5 acquisition.Sokal score low-risk group and 3M-EMR were associated with MR4.5 acquisition,and Sokal score low-risk group combined with 3M-EMR could better predict MR4.5. |
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