Contributions
Abstract: EP669
Type: E-Poster Presentation
Session title: Chronic myeloid leukemia - Clinical
Background
There are limited studies comprehensively comparing the significance between Sokal and EUTOS long-term survival (ELTS) scores in patients with chronic-phase chronic myeloid leukemia (CML-CP) receiving tyrosine kinase inhibitor (TKI) therapy.
Aims
To compare the significance of the Sokal and ELTS scores in predicting the therapy responses and outcomes in CML-CP patients receiving front-line imatinib or the second generation (2G) TKI therapy.
Methods
Data from consecutive patients with newly-diagnosed CML-CP from January 2006 to August 2020 were reviewed. Propensity score matching (PSM) was performed to explore the impact of front-line TKI therapy choice in the CML-CP patients based on the Sokal or ELTS score.
Results
Data from 1559 CML-CP patients receiving front-line imatinib (n = 1331) or 2G TKI (n = 228) therapy were analyzed. In multivariate analyses, both the Sokal and ELTS scores could predict the probabilities of achieving complete cytogenetic response (CCyR) (ref. low-risk; Sokal: intermediate-risk, HR, 0.8 [0.7, 0.9], p = 0.005; high-risk, HR, 0.7 [0.6, 0.8], p < 0.001; ELTS: intermediate-risk, HR, 0.9 [0.7, 1.0], p = 0.080; high-risk, HR, 0.6 [0.5, 0.8], p < 0.001) and major molecular response (MMR) (ref. low-risk; Sokal: high-risk, HR, 0.8 [0.7, 1.0], p = 0.014; ELTS: intermediate-risk, HR, 0.8 [0.6, 0.9], p = 0.003; high-risk, HR, 0.6 [0.4, 0.8], p < 0.001) and failure-free survival (FFS) (ref. low-risk; Sokal: intermediate-risk, HR, 1.7 [1.3, 2.3], p = 0.001; high-risk, HR, 2.0 [1.5, 2.8], p < 0.001; ELTS: intermediate-risk, HR, 1.5 [1.2, 2.0], p = 0.003; high-risk, HR, 2.7 [1.9, 3.8], p < 0.001) and progression-free survival (PFS) (ref. low-risk; Sokal: intermediate-risk, HR, 2.1 [1.2, 3.5]; p = 0.006; ELTS: intermediate-risk, HR, 1.7 [1.0, 2.7]; p = 0.035; high-risk, HR, 3.9 [2.2, 6.7], p < 0.001) in all patients. However, the ELTS score rather than the Sokal score was significantly-associated with the probabilities of achieving MR4.5 (ref. low-risk; intermediate-risk, HR, 0.8 [0.6, 1.0], p = 0.046; high-risk, HR, 0.6 [0.4, 0.9], p = 0.026) and overall survival (OS) (ref. low-risk; intermediate-risk, HR, 1.8 [1.0, 3.2], p = 0.063; high-risk, HR, 5.0 [2.7, 9.1], p < 0.001). Similar findings were observed in those receiving front-line imatinib therapy. However, in those receiving front-line 2G TKI therapy, only the ELTS score could predict the probabilities of achieving CCyR, MMR, FFS and PFS, especially in the high-risk subgroup identified by the ELTS score who had lower probabilities of achieving CCyR (HR, 0.4 [0.2, 0.6], p < 0.001) and MMR (HR, 0.3 [0.1, 0.5], p < 0.001] and had inferior FFS (HR, 3.6 [1.8, 7.0], p < 0.001) and PFS (HR, 3.3 [1.2, 9.2], p = 0.022) than the low-risk subgroup. In the PSM analysis, although the intermediate-risk subgroup identified by both the Sokal (n = 267, 34.9%) and ELTS (n = 69, 31.5%) scores receiving front-line 2G-TKI therapy had higher 7-year probabilities of achieving CCyR (p < 0.001 and p < 0.001) and MMR (p = 0.003 and p < 0.001) and FFS (p = 0.012 and p = 0.004) than those receiving front-line imatinib therapy, the advantage for predicting the probability of PFS (p = 0.058) was only shown in those by the ELTS score.
Conclusion
Our findings provide evidence supporting the higher predictive performance of the ELTS score than the Sokal score in CML-CP patients receiving TKI therapy, especially front-line 2G TKI therapy. Patients identified as intermediate-risk by the ELTS score might benefit more from front-line 2G TKI therapy.
Keyword(s): Chronic myeloid leukemia, Prediction, Risk factor, Tyrosine kinase inhibitor
Abstract: EP669
Type: E-Poster Presentation
Session title: Chronic myeloid leukemia - Clinical
Background
There are limited studies comprehensively comparing the significance between Sokal and EUTOS long-term survival (ELTS) scores in patients with chronic-phase chronic myeloid leukemia (CML-CP) receiving tyrosine kinase inhibitor (TKI) therapy.
Aims
To compare the significance of the Sokal and ELTS scores in predicting the therapy responses and outcomes in CML-CP patients receiving front-line imatinib or the second generation (2G) TKI therapy.
Methods
Data from consecutive patients with newly-diagnosed CML-CP from January 2006 to August 2020 were reviewed. Propensity score matching (PSM) was performed to explore the impact of front-line TKI therapy choice in the CML-CP patients based on the Sokal or ELTS score.
Results
Data from 1559 CML-CP patients receiving front-line imatinib (n = 1331) or 2G TKI (n = 228) therapy were analyzed. In multivariate analyses, both the Sokal and ELTS scores could predict the probabilities of achieving complete cytogenetic response (CCyR) (ref. low-risk; Sokal: intermediate-risk, HR, 0.8 [0.7, 0.9], p = 0.005; high-risk, HR, 0.7 [0.6, 0.8], p < 0.001; ELTS: intermediate-risk, HR, 0.9 [0.7, 1.0], p = 0.080; high-risk, HR, 0.6 [0.5, 0.8], p < 0.001) and major molecular response (MMR) (ref. low-risk; Sokal: high-risk, HR, 0.8 [0.7, 1.0], p = 0.014; ELTS: intermediate-risk, HR, 0.8 [0.6, 0.9], p = 0.003; high-risk, HR, 0.6 [0.4, 0.8], p < 0.001) and failure-free survival (FFS) (ref. low-risk; Sokal: intermediate-risk, HR, 1.7 [1.3, 2.3], p = 0.001; high-risk, HR, 2.0 [1.5, 2.8], p < 0.001; ELTS: intermediate-risk, HR, 1.5 [1.2, 2.0], p = 0.003; high-risk, HR, 2.7 [1.9, 3.8], p < 0.001) and progression-free survival (PFS) (ref. low-risk; Sokal: intermediate-risk, HR, 2.1 [1.2, 3.5]; p = 0.006; ELTS: intermediate-risk, HR, 1.7 [1.0, 2.7]; p = 0.035; high-risk, HR, 3.9 [2.2, 6.7], p < 0.001) in all patients. However, the ELTS score rather than the Sokal score was significantly-associated with the probabilities of achieving MR4.5 (ref. low-risk; intermediate-risk, HR, 0.8 [0.6, 1.0], p = 0.046; high-risk, HR, 0.6 [0.4, 0.9], p = 0.026) and overall survival (OS) (ref. low-risk; intermediate-risk, HR, 1.8 [1.0, 3.2], p = 0.063; high-risk, HR, 5.0 [2.7, 9.1], p < 0.001). Similar findings were observed in those receiving front-line imatinib therapy. However, in those receiving front-line 2G TKI therapy, only the ELTS score could predict the probabilities of achieving CCyR, MMR, FFS and PFS, especially in the high-risk subgroup identified by the ELTS score who had lower probabilities of achieving CCyR (HR, 0.4 [0.2, 0.6], p < 0.001) and MMR (HR, 0.3 [0.1, 0.5], p < 0.001] and had inferior FFS (HR, 3.6 [1.8, 7.0], p < 0.001) and PFS (HR, 3.3 [1.2, 9.2], p = 0.022) than the low-risk subgroup. In the PSM analysis, although the intermediate-risk subgroup identified by both the Sokal (n = 267, 34.9%) and ELTS (n = 69, 31.5%) scores receiving front-line 2G-TKI therapy had higher 7-year probabilities of achieving CCyR (p < 0.001 and p < 0.001) and MMR (p = 0.003 and p < 0.001) and FFS (p = 0.012 and p = 0.004) than those receiving front-line imatinib therapy, the advantage for predicting the probability of PFS (p = 0.058) was only shown in those by the ELTS score.
Conclusion
Our findings provide evidence supporting the higher predictive performance of the ELTS score than the Sokal score in CML-CP patients receiving TKI therapy, especially front-line 2G TKI therapy. Patients identified as intermediate-risk by the ELTS score might benefit more from front-line 2G TKI therapy.
Keyword(s): Chronic myeloid leukemia, Prediction, Risk factor, Tyrosine kinase inhibitor