Hi Tracey,
This is a good point and I'm glad you brought it up as it is worth
discussing further. My post eluded to increased risk from a high
Sokal score. Data presented at ASH this year showed the surprising
result that Sokal scores continue to be a strong prognostic indicator
even in the Gleevec era.
For some background, Sokal scores (and later Hasford scores) were
used back when Hydrea and later IFN were the treatment options of
choice. More recently however, the Sokal ranking system has pretty
much been replaced by % blasts by most Heme/oncs. The blast
percentage is used to determine the staging of the disease (chronic,
accelerated, blast) and therefore the associated risk for that stage.
The interesting thing about the Sokal score is that it can be used to
screen patients in the same stage with similar % blasts.
My assumption, was that John (like myself) would have an elevated
Sokal score for a CP patient because of his 486,000 WBC. It would
surprise me for example that someone would have such a high WBC and
not associated Sokal factors such as a large spleen. I wasn't sure
though, which was why I asked if he also had a large spleen.
For those who are interested, the Sokal score can be calculated using
the following forumula:
Relative risk = 0.0016(Age - 43.4) + 0.0345(spleen size in cm -
7.51) + 0.188[(platelets/700)2 - 0.563] + 0.0887(blasts - 2.10)
Low risk: <0.8 High risk: >1.2
Regards,
Mark
--- In [email protected], "traceyincanada" <[EMAIL PROTECTED]>
wrote:
>
> Hi,
>
> To my knowledge, the WBC has no effect on risk or prognosis. I've
> seen patients with WBC's in the 500's who were in solid chronic
> phase and others with a WBC of 12 in blast phase. A more accurate
> indication of risk is platelet count, blast count and basophil
count
> and spleen size.
>
> I just didn't want John to worry unnessesarily.
>
> Take care,
> Tracey
>
> --- In [email protected], "mpetersen123" <[EMAIL PROTECTED]>
wrote:
> >> Hi John,
> >
> > Be aware that with such a high WBC count you'll likely be in a
> > slightly higher risk group so it's a good idea to have more
> frequent > WBC and PCRs.
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