Impact of risk score calculations in choosing front-line tyrosine kinase inhibitors for patients with newly diagnosed chronic myeloid leukemia in the chronic phase

The approval of multiple tyrosine kinase inhibitors targeting BCR-ABL has broadened the number of available therapeutic options for chronic myeloid leukemia in the chronic phase (CML-CP). This provides an impetus for optimizing prognostic risk score systems that can guide treatment decisions. Presently, three risk scores-the Sokal, Hasford, and European Treatment and Outcome Study (EUTOS) metrics-have been implemented clinically in CML-CP. While these three formulations all endeavor to gauge likely disease course, they differ from one another in several important respects, with potential implications for prognosis and therapy. Here, we review these risk scores and propose how prognostic systems in CML-CP might be refined to direct patients to optimally effective therapies as efficiently and accurately as possible.