ELTS (The EUTOS long-term survival score) is prognosis of long-term survival in chronic myeloid leukemia (CML) patients: online calculation of the prognostic risk group of the ELTS score. For adult patients diagnosed with chronic myeloid leukemia (CML).

The ELTS score is calculated by the formula:

ELTS score = 0.0025 x (age in completed years/10)³ + 0.0615 x spleen size below costal margin + 0.1052 x blasts in peripheral blood + 0.4104 x (platelet count/1000)^-0.5

When choosing your values in order to calculate the ELTS score for your patient, please consider the following:

• All variables should be evaluated at diagnosis of the patient.
• Age should be given in completed years. The score was validated for patients above 18 years of age.
• Spleen size should be inserted in cm below costal margin.
• The percentage of blasts in peripheral blood should be rounded to an integer, e.g. 0, 2 or 7.
• The platelet count should be given in 10⁹/L.

The ELTS score is rounded to four decimal places.

• An ELTS score value ≤ 1.5680 defines the low-risk group.
• An ELTS score value > 1.5680 but ≤ 2.2185 defines the intermediate-risk group.
• An ELTS score value > 2.2185 defines the high-risk group.

The EUTOS long-term survival score (ELTS) was developed on the basis of 2,205 adult patients with Philadelphia chromosome-positive and/or BCR-ABL1-positive chronic-phase CML, transcript type b2a2 and/or b3a2, and any form of imatinib-based treatment within six months from diagnosis. All patients had been enrolled in controlled clinical trials (in-study patients) and became part of the in-study section of the European Treatment and Outcome Study (EUTOS) registry.

Using the Fine-Gray model, the influence of potential prognostic factors on the probabilities of dying due to CML was analyzed. Candidate prognostic factors were age, sex, spleen size below costal margin, hemoglobin, white blood cell count, blasts, basophils, eosinophils (all in peripheral blood), and platelet count. All variables were evaluated at diagnosis prior to any CML therapy.

The probability of dying of CML was significantly increased by higher age, a bigger spleen size, a higher percentage of peripheral blasts and low platelet counts. To aid medical decision making, the new score was categorized into three significantly different risk groups. Any pairwise comparison between two of the three risk groups led to statistical and clinically relevant significance when performed in an independent validation sample comprising 1,120 patients.

In the in-study section as well as in the validation sample, the ELTS score provided a superior prognostic discrimination of the probabilities of CML-related death and of overall survival as compared with the Sokal, the Euro or the EUTOS score. About 60 % of the patients were allocated to low-risk group with a very promising long-term outcome when starting treatment with imatinib. This outcome is clinically highly relevant as imatinib-based treatment is the primary choice in many countries and its use will be further boosted by its availability as a generic drug.

As a baseline score, the ELTS score serves the prospective assessment of long-term antileukemic efficacy and overall survival of patients with first-line imatinib therapy. The score supports the selection and development of risk-adjusted treatments, the adjustment of imbalances between treatment groups in clinical trials, and improves outcome comparison of different studies.

A source:
Pfirrmann M, Baccarani M, Saussele S, Guilhot J, Cervantes F, Ossenkoppele G, Hoffmann V S, Castagnetti F, Hasford J, Hehlmann R, Simonsson B. Prognosis of long-term survival considering disease-specific death in patients with chronic myeloid leukemia. Leukemia 2015. Article in press.

Read also:

Register on our website right now to have access to more learning materials!

Register

Baseline Cardiovascular Risk Assessment in Cancer Patients Scheduled to Receive Cardiotoxic Cancer Therapies (Anthracycline Chemotherapy) – Online Calculator

Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies (Anthracycline Chemotherapy)…

Read More

National Institutes of Health Stroke Scale (NIHSS) – Online calculator

The National Institutes of Health Stroke Scale (NIHSS) is a scale designed to assess the…

Read More

Charlson Comorbidity Index (CCI) Online Calculator

Charlson Comorbidity Index predicts 10-year survival in patients with multiple comorbidities.

Loading...

Email (indicate if you want the results to be sent to your email)

Date of assessment

---

Age *

<50 years

50–59 years

60–69 years

70–79 years

≥80 years

Myocardial infarction *

History of definite or probable MI (EKG changes and/or enzyme changes)

No

Yes

Congestive heart failure *

Exertional or paroxysmal nocturnal dyspnea and has responded to digitalis, diuretics, or afterload reducing agents

No

Yes

Peripheral vascular disease *

Intermittent claudication or past bypass for chronic arterial insufficiency, history of gangrene or acute arterial insufficiency, or untreated thoracic or abdominal aneurysm (≥6 cm)

No

Yes

Cerebrovascular accident or Transient ischemic attack *

History of a cerebrovascular accident with minor or no residua and transient ischemic attacks

No

Yes

Dementia *

Chronic cognitive deficit

No

Yes

Chronic obstructive pulmonary disease *

No

Yes

Connective tissue disease *

No

Yes

Peptic ulcer disease *

Any history of treatment for ulcer disease or history of ulcer bleeding

No

Yes

Liver disease *

Severe = cirrhosis and portal hypertension with variceal bleeding history, moderate = cirrhosis and portal hypertension but no variceal bleeding history, mild = chronic hepatitis (or cirrhosis without portal hypertension)

None

Mild

Moderate to severe

Diabetes mellitus *

None or diet-controlled

Uncomplicated

End-organ damage

Hemiplegia *

No

Yes

Moderate to severe chronic kidney disease *

Severe = on dialysis, status post kidney transplant, uremia, moderate = creatinine >3 mg/dL (0.27 mmol/L)

No

Yes

Solid tumor *

None

Localized

Metastatic

Leukemia *

No

Yes

Lymphoma *

No

Yes

AIDS *

No

Yes

---

Charlson Comorbidity Index

10-year survival

Details:

Reset

* Required

VariablePointsAge <50…

Read More

Multiple Myeloma Diagnostic Criteria – Online Calculator

Loading...

Email (indicate if you want the results to be sent to your email)

Date of assessment

---

≥1 of the following (A or B)

*

A. Clonal bone marrow plasma cells ≥10%

B. Biopsy-proven bony or extramedullary plasmacytoma

≥1 myeloma defining event (C1 or C2)

• C1. End organ damage attributable to underlying plasma cell disorder (≥1 of the following): *

o Hypercalcemia (Serum calcium >1 mg/dL (>0.25 mmol/L) higher than upper limit of normal or >11 mg/dL (>2.75 mmol/L))

o Renal insufficiency (Creatinine clearance<40 mL per min or serum creatinine >2 mg/dL (177 μmol/L))

o Anemia (Hemoglobin >2 g/dL (20 g/L) below lower limit of normal

o Bone lesions (≥1 osteolytic lesion on skeletal x-ray

• C2. ≥1 of the following biomarkers of malignancy: *

o Clonal bone marrow plasma cells ≥60%

o Involved:uninvolved sFLC ratio ≥100

o >1 focal lesion on MRI

---

Result

Diagnostic result Negative. Not positive for multiple myeloma by IMWG criteria

Diagnostic result Positive for multiple myeloma by IMWG criteria

Details:

Reset

* Required

For Multiple Myeloma Diagnostic Criteria assessment necessary to provide selection of the…

Read More

Revised Multiple Myeloma International Staging System (R-ISS) Online Calculator

Revised Multiple Myeloma International Staging System (R-ISS) – prognostication tool for myeloma patients based on…

Read More

Multiple Myeloma International Staging System (ISS) Online Calculator

Multiple Myeloma International Staging System (ISS) prognosticates the severity of multiple myeloma based on routinely…

Read More