EUTOS Score for Chronic Myelogenous Leukemia (CML)

Why Use

Estimates response to therapy to, and survival on, the reference TKI (tyrosine kinase inhibitor) imatinib. Only requires two values, which can be clinically detected prior to completing a bone marrow biopsy.

When to Use

Newly-diagnosed CML patients prior to discussions regarding prognosis and treatment options.

Formula

Pearls / Pitfalls

The EUTOS (European Treatment and Outcome Study) Score predicts survival and can also be used to predict the probability of complete cytogenetic response at 18 months. Has better predictive value than the Sokal Score . Spleen size estimation is subjective; however, that subjectivity is also included in other CML prognostic scores. Developed in patients treated with imatinib, so outcomes may not apply with newer generation therapies.

Management

Though there is no broad consensus on management, a conservative strategy is to treat low-risk patients with imatinib and reserve newer-generation TKIs for high risk patients.

Critical Actions

Can only be applied to a newly-diagnosed patient before starting therapy.

More Information

Interpretation: EUTOS Score Risk category 5 year progression-free survival* CCyR at 18 months* ≤87 Low 90% 86% >87 High 82% 66% *Response rates based on imatinib treatment only. CCyR, complete cytogenetic response rate.