In a nutshell
The study tested whether the EUTOS long-term survival (ELTS) score is efficient to evaluate treatment response in patients with chronic myeloid leukemia (CML), treated with imatinib (Gleevec). The main finding was that ELTS could effectively predict treatment outcomes among such patients in the real world.
Initial therapy with imatinib improved survival among patients with CML. Most causes of mortality in such patients are no longer CML. Therefore, it is important to consider CML-related deaths to indicate treatment outcomes.
ELTS is a new method that effectively determined the risks of CML-related death in European patients. It involves calculations based on age, the spleen size, and blood counts of patients. Applications of ELTS in real-world studies in Asia, especially China are lacking.
Methods & findings
The study analyzed the records of 462 adult patients with newly diagnosed CML. They were initially treated with imatinib. The average follow-up was 69 months. Patients were divided into 3 groups using the ELTS method. 230 patients were classified as low-risk, 168 were intermediate-risk and 64 were high-risk. The predictive capacity of ELTS was compared with established scoring systems such as the Sokal (S), Hasford (H) and EUTOS.
Complete cytogenetic response (CCyR) is achieved when no cell with the leukemic gene is left in the bone marrow. ELTS predicted that 88% of low-risk, 72% of intermediate-risk and 66% of high-risk patients will achieve CCyR in 18 months. This was similar to what S and H systems predicted.
93% of low-risk, 84% of intermediate-risk and 83% of high-risk patients were estimated to survive for 5 years without leukemia’s progression by ELTS. These were similar to the results of the EUTOS system.
The ELTS estimated that the risks of CML-related death in 5 years would be 11% in high-risk patients, 5% in intermediate-risk patients and 2% among low-risk patients. The other systems could not accurately make such a prediction.
The bottom line
The authors concluded that ELTS could predict effectively treatment outcomes and risk of CML-related deaths in imatinib-treated patients with CML.
The fine print
This study was performed on Chinese patients only. Similar studies can be performed on other populations.
Published By :
Cancer management and research
Feb 29, 2020