Validation of Eutos Long-Term Survival Score in Chronic Myeloid Leukemia Patients Treated with Second Generation Tyrosine-Kinase Inhibitor- Experience from A Low-Middle Income Country
摘要
Chronic myeloid leukemia (CML) is a clonal disorder of myeloid lineage. Our study was done to compare the three risk groups and evaluate utility and applicability of the ELTS scoring system in predicting survival of CML in chronic phase(CP) on treatment with nilotinib in a resource limited setting. A cross sectional study was conducted at National Institute of Blood Diseases and Bone marrow transplantation, Karachi, Pakistan from January 2015 to December 2022. A total of 204 diagnosed CML patients were included. Risk stratification was done based on the Sokal, EUTOS and ELTS scores. A total of 204 patients were enrolled in the study. Out of total, 130 (64%) were males. The median age was 37(ranging 15–77 years). The median follow-up duration was 40 months and median spleen size was 5.6 (ranging, 1.6–14 cm). On the basis of ELTS score, 86 (42%) patients were stratified as low, intermediate 91 (45%), and 27 (13%) patients were high-risk group. Patients stratified as high-risk according to ELTS scoring had a substantial lower MMR accomplishment. Moreover, the 12 months MMR accomplishment rates were 50 (39%) in low, 55 (43%)(p = 0.03). ELTS and EUTOS scoring system was also able to anticipate the DMR accomplishment (p = < 0.001). Our study implied that the new ELTS score can be used to predict prognosis in CML patients in CP treated with upfront nilotinib specifically in terms of molecular response and must be incorporated at disease baseline to predict disease prognosis and choice of tyrosine kinase inhibitor (TKI).