Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    Sokal Index for Chronic Myelogenous Leukemia (CML)

    Predicts survival of CML based on clinical and lab information.


    Use to predict prognosis at the time of CML diagnosis, before starting treatment.

    When to Use
    Why Use

    In the US, the Sokal Score can be used to determine risk and decide on therapy based on the NCCN guidelines for CML. While the EUTOS score is easier to calculate and more accurately identifies high risk patients in the era of tyrosine kinase inhibitors, it has not been adopted by the NCCN guidelines.

    • The Sokal Index, also referred to as the Sokal Score, was developed using patients treated in the pre-tyrosine kinase inhibitor era and thus can not necessarily be applied today. Survival outcomes have drastically improved since then.
    • Although scores are stratified into low, intermediate, and high risk, some studies have shown that low and intermediate risk have similar outcomes.
    • Some advocate combining the Sokal and EUTOS Scores for better predictive value.
    • NCCN guidelines for CML treatment recommend use of the Sokal and Hasford Scores over EUTOS for clinical risk stratification.
    • The Sokal Score is also preferentially used in clinical trials so that comparisons can be made to prior trials.
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    Next Steps
    Creator Insights
    Dr. Joseph E. Sokal

    About the Creator

    Joseph E. Sokal, MD, (d. 1988) was a researcher in cancer treatment and a scholar in residence at Duke University. Previously, he was chief cancer research clinician at Roswell Park Memorial Institute in Buffalo and an assistant professor at Yale University.

    To view Dr. Joseph E. Sokal's publications, visit PubMed

    Content Contributors
    About the Creator
    Dr. Joseph E. Sokal
    Content Contributors