Prognostic Scoring in Patients of Chronic Myeloid Leukemia: Correlation between Sokal and Hasford Scoring Systems

Abstract

Background: Chronic myeloid leukaemia (CML) is a clonal myeloproliferative disorder of transformed primitive hematopoietic progenitor cells. Chronic myeloid leukaemia is one of the commonest leukemias. Patients of CML are usually subjected to risk stratification according to various prognostic criteria. The Sokal scoring system is popular as a prognostic discriminator for survival in patients treated with chemotherapy. Hasford et al proposed a new CML scoring system referred to as Euro score.

Objective: Correlation of various prognostic risk groups of Hasford scoring system with comparable prognostic groups of Sokal scoring system in chronic myeloid leukemia.

Material and Methods: This descriptive study was conducted at department of pathology, Pakistan institute of medical sciences from March 2003 to October 2006. A total of 59 consecutive freshly diagnosed untreated cases of CML were subjected to Sokal and Hasford scoring systems, and the results were correlated with each other.

Results: In total of 59 cases of CML age range was from 8 to 70 years with mean ± SD of 35.39 ± 17.12 years. Six (10.1%) patients belonged to pediatric age group i.e. <15 years. Male: female ratio was 1.3:1.  According to Sokal criteria about half of the patients were found in intermediate risk group; 44% were in high risk group and only 5% in low risk group. Using Hasford scoring system, 44% of patients were placed in intermediate risk, 30.5% in high risk and 15% in low risk groups.

Conclusion: Hasford score identifies more patients still in low risk group as compared to Sokal scoring system and prospective studies should be carried out to see overall survival and disease free survival of these risk groups.