Validity of Prognostic Scoring Systems in Egyptian Patient with Chronic Myeloid Leukemia

Abstract

Chronic myeolid leukemia (CML) is a major model of oncogenesis results from expression of the constitutive tyrosine kinase activity of the Bcr-Abl oncoprotein. imatinib, a tyrosine kinase inhibitor (TKI) is highly effective in the treatment of CML. However, some patients treated with imatinib will fail to respond , will respond suboptimully, or will relapse because of primary of acquired resistance or intolerance. In order to predict the outcome at the patients, Sokal score was developed in the era of chemotherapy, as well as euro score was proposed in the time of interferon-alfa administration while EUTOS score developed in the era of TKIs. The assessment of early response to tyrosine kinase inhibitor (TKI) treatment has become an important tool in the clinical management of patients with chronic myeloid leukemia (CML). The early identification of patients expecting poor outcomes is crucial to offer an alternative TKI regimen or in some cases stem cell transplantation before disease progression occurs. Still, scoring systems are the most reliable clinical prognostic method for evaluating patients with CML. Studies validating the 3 scores have shown contradicting results. One potential reason for these differences is heterogenecity in the type or dose of up front treatments across studies. Response to TKIs among Egyptian patients has shown a promising results.