Staging of Chronic Myeloid Leukaemia

Abstract

The prognostic value of 9 clinical and hematological features, recorded at diagnosis in chronic myeloid leukemia (CML), was analyzed in 2 series of patients. Six features were associated with a poor prognosis: splenomegaly (> 15 cm below the costal margin), hepatomegaly (> 6 cm below the costal margin), thrombocytopenia (< 150 .times. 109/l) or thrombocytosis (> 500 .times. 109/l), a leukocyte count > 100 .times. 109/l, peripheral blood non-granulated precursors (blast cells) > 1% and peripheral blood granulated precursors (promyelocytes and myelocytes) > 20%. Depending on the number of negative prognostic factors, patients were divided into 3 categories: group 1 (0 or 1 factor), group 2 (2 or 3 factors) and group 3 (4, 5 or 6 factors). Survival was significantly different in the 3 groups (P < 0.0005) and this was independent of age (below and above 50). The prognostic value of the classification was confirmed in a 3rd series of 153 patients. This classification provides a useful tool to identify prognostic categories in CML, and thus allows a proper allocation of patients to different therapies.