Prognostic discrimination based on the EUTOS long-term survival score within the International Registry for Chronic Myeloid Leukemia in children and adolescents

Frédéric Millot, Joëlle Guilhot, Meinolf Suttorp, Adalet Meral Güneş, Petr Sedlacek, Eveline De Bont, Chi Kong Li, Krzysztof Kalwak, Birgitte Lausen, Srdjana Culic, Michael Dworzak, Emilia Kaiserova, Barbara De Moerloose, Farah Roula, Andrea Biondi, André Baruchel, Frédéric Millot, Joëlle Guilhot, Meinolf Suttorp, Adalet Meral Güneş, Petr Sedlacek, Eveline De Bont, Chi Kong Li, Krzysztof Kalwak, Birgitte Lausen, Srdjana Culic, Michael Dworzak, Emilia Kaiserova, Barbara De Moerloose, Farah Roula, Andrea Biondi, André Baruchel

Abstract

The EUTOS Long-Term Survival score was tested in 350 children with chronic myeloid leukemia in first chronic phase treated with imatinib and registered in the International Registry for Childhood Chronic Myeloid Leukemia. With a median follow up of 3 years (range, 1 month to 6 years) progression and/or death (whichever came first) occurred in 23 patients. For the entire cohort of patients the 5-year progression-free survival rate was 92% (95% CI: 87%-94%) and the 5-year survival accounting for chronic myeloid leukemia deaths was 97% (95% CI: 94%-99%). Of the 309 patients allocated to low (n=199), intermediate (n=68) and high (n=42) risk groups by the EUTOS Long-Term Survival score, events (progression and/or death) occurred in 6.0%, 8.8% and 26.2%, respectively. Estimates of the 5-year progression-free survival rates according to these three risk groups were 96% (95% CI: 92%-98%), 88% (95% CI: 76%-95%) and 67% (95% CI: 48%-81%), respectively. Differences in progression-free survival according to these risk groups were highly significant (P<0.0001, overall). The EUTOS Long-Term Survival score showed better differentiation of progression-free survival than the Sokal (<45 years), Euro and EUTOS scores in children and adolescents with chronic myeloid leukemia and should be considered in therapeutic algorithms. (Trial registered at: www.clinicaltrials.gov NCT01281735).

Copyright© 2017 Ferrata Storti Foundation.

Figures

Figure 1
Figure 1
Progression-free survival stratified according to risk categorization by the four scores. (A) Sokal score, (B) Euro score, (C) EUTOS score, (D) EUTOS Long-Term Survival (ELTS) score. Green represent low risk patients, orange represent intermediate risk patients and red represents high-risk patients.

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