Description

Milojkovic et al developed a score for predicting the response of a patient with chronic myelogenous leukemia (CML) to second generation tyrosine kinase inhibitors. The authors are from Hammersmith Hospitals, Imperial College London, Beatson West of Scotland Cancer Center, University of Glasgow, and the Western General Hospital in Edinburgh.


 

Patient selection: chronic myelogenous leukemia (CML)

 

Parameters:

(1) best cytogenetic response to imatinib

(2) Sokal risk group (28.12.04)

(3) neutropenia during imatinib therapy

Parameter

Finding

Points

best cytogenetic response

complete remission (0% Ph-positive metaphases)

0

 

1 to 94% Ph-positive metaphases

1

 

95-100% Ph-positive metaphases

3

Sokal risk group

low

0

 

intermediate

0.5

 

high

0.5

neutropenia during imatinib

none

0

 

recurrent episodes of Grade III or IV neutropenia requiring dose reduction

1

 

total score =

= SUM(points for all 3 paramters)

 

Interpretation:

• minimum score: 0

• maximum score: 4.5

• The higher the score the greater the risk of a incomplete response to therapy with a second generation tyrosine kinase inhibitor.

 

Total Score

Risk Group

Complete Cytogenetic Response at 2 Years

0, 0.5, 1

good

100%

1.5, 2.0, 2.5

intermediate

52-63%

3, 3.5. 4, 4.5

poor

14-17%

 


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