Staging of Chronic Myeloid Leukaemia

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Abstract
Summary. The prognostic value of nine clinical and haematological features, recorded at diagnosis in chronic myeloid leukaemia (CML), was analysed in two distinct series of patients. One series (116 cases) was collected at a single hospital over a 12‐year period. The second series (139 cases) was collected from a multicentre trial over a 20‐month period. Six features were associated with a poor prognosis: splenomegaly (more than 15 cm below the costal margin), hepatomegaly (more than 6 cm below the costal margin), thrombocytopenia (< 150 109/l) or thrombo‐cytosis (>500 109/l), a leucocyte count above 100 109/1, peripheral blood non‐granulated precursors (blast cells) above 1%, and peripheral blood granulated precursors (promyelocytes and myclocytcs) above 20%. Depending on the number of negative prognostic factors, patients were divided into three categories: group I (0 or 1 factor), group II (2 or 3 factors) and group III (4, 5 or 6 factors). Survival was significantly different in the three groups (P < 0.0005), and this was independent of age (below and above 50). The prognostic value of the classification was confirmed in a third scries of 153 patients. We suggest that this classification provides a useful tool to identify prognostic categories in CML, and thus allows a proper allocation of patients to different therapies.