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Validation of the Hasford score in a demographic study in chronic granulocytic leukaemia
M J Thomas1, J A Irving, A L Lennard
1University of Newcastle upon Tyne, Newcastle upon Tyne NE1 4LP, UK.
Insights
The Hasford score accurately predicts survival in younger chronic granulocytic leukaemia (CGL) patients treated with interferon. This prognostic tool aids treatment decisions when stem cell transplants are unavailable.
Area of Science:
- Hematology
- Oncology
- Medical Statistics
Background:
- Chronic granulocytic leukaemia (CGL) is a rare hematologic malignancy.
- Curative treatment options like allogeneic stem cell transplant are not universally available for CGL patients.
- Accurate survival prediction is crucial for informed clinical decision-making and treatment planning.
Purpose of the Study:
- To evaluate the prognostic accuracy of the Hasford and Sokal scores in an unselected CGL patient cohort.
- To determine the utility of these scoring systems in predicting survival for CGL patients.
- To identify which scoring system is more effective for stratifying risk in interferon-treated CGL patients.
Main Methods:
- Analysis of survival data from an unselected population-based cohort of chronic granulocytic leukaemia patients.
- Application and comparison of both the Hasford and Sokal prognostic scoring systems.
- Statistical evaluation of the predictive power of each score on patient survival.
Main Results:
- Neither the Hasford nor the Sokal score predicted survival for the overall CGL patient group.
- In younger patients (< 60 years) receiving interferon therapy, the Hasford score demonstrated significant predictive capability (p = 0.01).
- The Hasford score stratified younger, interferon-treated patients into distinct survival groups with 5-year survival rates of 77%, 33%, and 14%.
Conclusions:
- The Hasford score is a valuable prognostic tool for predicting survival specifically in younger chronic granulocytic leukaemia patients treated with interferon.
- The Sokal score showed limited predictive value in this cohort.
- These findings support the use of the Hasford score to guide treatment strategies for specific CGL patient subgroups.
Abstract:
Chronic granulocytic leukaemia (CGL) is a rare disease. For most patients the only curative treatment (an allogeneic stem cell transplant) is not available. Survival varies between a few months to many years from diagnosis, and an accurate prediction of the duration of survival could help patients and clinicians make informed decisions about the many treatment options. In 1984, the Sokal score was introduced to stratify patients into risk groups. Recently, a new prognostic scoring system was proposed by Hasford and co-workers for interferon treated patients. We have analysed survival on an unselected population based cohort of patients using both the Hasford and the Sokal scores. In the group overall, neither score was predictive of survival, but in younger patients (< 60 years) treated with interferon, the Hasford score was highly predictive of survival, dividing patients into groups with a five year survival of 77% (45 patients) v 33% (six patients) v 14% (31 patients) (p = 0.01).