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Natali Rossi clinical and laboratory values

According to four weighted clinical and laboratory values (age, spleen size, platelet count, and peripheral blood blasts cell percentage), patients can be classified into three prognostic groups for a 4-year survival; with a survival probability up to 62%, 43% and 33%, patients were segregated respectively into low-risk, intermediate-risk and high-risk groups. The Sokal score in an individual patient is no more than the relative risk (RR) for survival and it is based on the Cox proportional hazards equation using four patient variables (namely platelet count, age, blast count and spleen size). Natali Rossi.
Natali Rossi
new prognostic classification
This model has been recently revised with a new prognostic classification, the Hasford score, which derived from the study of over 900 CML patients on interferon (IFN) and calculated using the classic four Sokal variables together with two others, namely blood percentage of eosinophils and basophils (Table 1B). In the new scoring system, patients were classified into the low-, intermediate- and high-risk groups according to a 5-year survival probability of 76%, 55% and 25% respectively. More recently, a new scoring system (European Treatment and Outcome Study [EUTOS] score) was developed by the European Leukemia-Net using data from 2,060 patients who were treated with imatinib-based regimens. Natali Rossi.
Natali Rossi
superior prognostic power
 The EUTOS score is similar to 23 the Sokal score, and patients are classified into two different prognostic groups (i.e. high and low risk) on the basis of the percentage of basophils in the peripheral blood and the spleen size at diagnosis.19 It has been suggested that the EUTOS score has superior prognostic power when compared with the Sokal and Hasford scores. 19 However, a Swedish study reported that the Sokal but not the EUTOS score predicted relative survival in CML patients. Natali Rossi.
Natali Rossi
prognostic classification score
20 Ideally, a prognostic classification score should be able to identify patients with poor risk independently of whether patients are treated in the community or part of clinical trials. The Sokal score has been used for nearly 30 years and has been validated extensively in different clinical settings and therapies; clinicians need to be cautious before adopting a new prognostic system that has not yet been validated in a truly independent manner. Natali Rossi.
Natali Rossi
The mechanisms of progression
I.I.H. Disease progression and transformation The mechanisms of progression and transformation in CML to blast phase are complex and not entirely understood, partially still due to the lack of adequate animal models of BCR-ABL-induced leukaemia with a long, human-resembling chronic phase, necessary for right evaluation of the mechanisms involved in disease evolution. Numerous factors have been implicated as critical in the transformation from chronic to blastic phase CML. A) BCR-ABL1 expression: the constitutive expression of the BCR-ABL1 fusion gene is paramount in almost certainly causing CML and for its evolution. Natali Rossi.