Validation of the EUTOS Long-Term Survival Score in Chinese Chronic Myeloid Leukemia Patients Treated with Imatinib: A Multicenter Real-World Study
Received 6 November 2019
Accepted for publication 5 February 2020
Published 20 February 2020 Volume 2020:12 Pages 1293—1301
Checked for plagiarism Yes
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Peer reviewer comments 2
Editor who approved publication: Dr Eileen O'Reilly
Xiawan Yang, 1,* Yanliang Bai, 1,* Mingyue Shi, 1 Wanjun Zhang, 1 Junwei Niu, 1 Chengye Wu, 2 Lei Zhang, 2 Zhiwei Xu, 3 Xiang Liu, 4 Yuqing Chen, 1 Kai Sun 1
1Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Henan, People’s Republic of China; 2Institute of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Henan, People’s Republic of China; 3Department of Clinical Research Service Center, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Henan, People’s Republic of China; 4Department of Geriatric Medicine, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, Henan, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Kai Sun; Yuqing Chen
Department of Hematology, Zhengzhou University People’s Hospital and Henan Provincial People’s Hospital, No. 7 Weiwu Road, Jinshui District Zhengzhou, Henan 450003, People’s Republic of China
Tel +86-18237110038; +86-18697321863
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Purpose: To validate the clinical efficacy of the recently developed EUTOS long-term survival (ELTS) score in a real-world setting.
Patients and Methods: A total of 479 chronic myeloid leukemia (CML) patients treated with frontline imatinib between January 2010 and December 2017 were enrolled in this retrospective study. The ELTS score was evaluated on the end-points including complete cytogenetic response (CCyR), progression-free survival (PFS), overall survival (OS) and CML-related death, and the efficiency of the ELTS score was further compared with the historical Sokal, Hasford, EUTOS scores.
Results: With a median follow-up of 69 months (range, 9– 112 months), 462 evaluable patients were stratified into the ELTS low-risk (n = 230), ELTS intermediate-risk (n = 168) and ELTS high-risk (n = 64) groups. For the regular assessment indicators like CCyR, PFS and OS, the ELTS scoring system could effectively identify the corresponding risk groups, similarly with the results provided by previous scoring systems. With respect to the CML-related death, the ELTS score could accurately identify a high-risk group with a significantly higher risk of dying of CML, and the 5-year cumulative incidence occurred in the ELTS high-, intermediate-, and low-risk groups was 11% (95% CI: 3– 19%), 5% (95% CI: 1– 9%) and 2% (95% CI: 0– 4%), respectively. Most notably, the ELTS score outperformed the Sokal, Hasford and EUTOS scores without statistical difference among different risk groups.
Conclusion: The ELTS score could effectively predict the prognosis of imatinib-treated CML patients in real-life settings.
Keywords: chronic myeloid leukemia, tyrosine kinase inhibitors, Sokal, Hasford, EUTOS, EUTOS long-term survival score
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