Abstract
The introduction of tyrosine kinase inhibitors (TKI) in the treatment of Philadelphia chromosome-positive (Ph+) chronic myeloid leukemia (CML) has revolutionized the outcome, but the prognosis of the disease is still based on prognostic systems that were developed in the era of conventional chemotherapy and interferon (IFN)-alfa. A new prognostic score including only two variables, spleen size and basophils, was developed for the prediction of complete cytogenetic response (CCyR) and progression-free survival (PFS). The score was based on a large series of patients who were enrolled in prospective multicenter studies of first-line imatinib treatment. The prognostic value of the EUTOS (European Treatment and Outcome Study for CML) score has now been tested in an independent, multicenter, multinational series of 1288 patients who were treated first-line with imatinib outside prospective studies. It was found that also in these patients, the EUTOS prognostic score was predictive for CCyR, PFS and overall survival (OS). In addition, the prognostic value of the score was reported to be significant in seven of the eight other independent studies of almost 2000 patients that were performed in Europe, the Americas and Asia. The EUTOS risk score is a valid tool for the prediction of the therapeutic effects of TKI, particularly imatinib.
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Acknowledgements
The European Treatment and Outcome Study (EUTOS) is a project supported by the Novartis Oncology Europe through a contract with European LeukemiaNet and the University of Heidelberg (Germany).
Author Contributions
MB, VH (principal investigator) and MP designed the research. MB, FC, AT, AZ, AH, WP, J-LS JM, KI AC and GR collected the data. VH performed the statistical analysis. DL processed and analyzed the data. VH, MB and MP analyzed and interpreted the data and wrote the manuscript. All authors revised and approved the manuscript.
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VH (principal investigator) received funding from Novartis Pharma, and honoraria from Bristol Myers Squibb. MB and DL receive research funding from Novartis Pharma. FC has the role of a consultant, and received honoraria from Novartis Pharma and Bristol Myers Squibb. AT has the role of a consultant in Bristol Myers Squibb and Novartis Pharma. AZ received research funding from the University of Heidelberg. J-LS has the role of a consultant, received research grants and honoraria from Novartis Pharma, Bristol Myers Squibb and Pfizer. GR received honoraria from Novartis Pharma, Bristol Myers Squibb, Pfizer and Roche, and holds a consultancy role with Novartis Pharma and Bristol Myers Squibb. MP has the role of a consultant in Novartis Pharma and received honoraria from Bristol Myers Squibb. The remaining authors declare no conflict of interest.
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Hoffmann, V., Baccarani, M., Lindoerfer, D. et al. The EUTOS prognostic score: review and validation in 1288 patients with CML treated frontline with imatinib. Leukemia 27, 2016–2022 (2013). https://doi.org/10.1038/leu.2013.171
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DOI: https://doi.org/10.1038/leu.2013.171
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