validation of a new scoring system for treatment failure in cml patients on tyrosine knase inhibitors in a real world setting

Tyrosine kinase inhibitor (TKI) therapy has significantly improved the survival of patients with chronic phase chronic myeloid leukemia (CML), with a 10-year survival rate of approximately 90%.1 However, one-third of patients continue to experience treatment failure. Therapeutic failure occurs more frequently in patients at higher risk of disease progression and mortality during TKI therapy.2 According to the European LeukemiaNet (ELN) guidelines, a change in TKI therapy should be considered for patients who fail to achieve specific response milestones.3 Therefore, accurately predicting the likelihood of treatment failure in individuals with chronic phase CML is crucial to achieve precise response targets when selecting the initial TK. The risk stratification of CML patients was based on scores predicting overall survival since the pre-imatinib era. The Sokal risk score was published in 1984, while the EURO score was established in 1998 using data from CML patients receiving interferon-α therapy.4–5 After the introduction of imatinib, the EUTOS risk score was established in 2011 to predict the likelihood of achieving complete cytogenetic response (CCyR) at 18 months, serving as a proxy for survival.6