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

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Save your unit preferences in settings!

    Sokal Index for Chronic Myelogenous Leukemia (CML)

    Predicts survival of CML based on clinical and lab information.
    Favorite

    INSTRUCTIONS

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

    When to Use
    Pearls/Pitfalls
    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.
    years
    cm
    × 10³/µL
    %

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    Whether the patient meets milestones for cytogenetic and molecular response is more predictive of outcome once therapy is started.

    Management

    Although the Sokal Score has limited usefulness outside of clinical trials today, in general, low and intermediate risk patients can be started on standard dose imatinib, and high risk patients should be considered for newer generation TKIs or be monitored more closely to ensure complete molecular response.

    Critical Actions

    Can only be applied in a newly-diagnosed patient prior to starting therapy.

    Content Contributors
    Reviewed By
    • Michael Mauro, MD
    About the Creator
    Dr. Joseph E. Sokal
    Are you Dr. Joseph E. Sokal?
    Content Contributors
    Reviewed By
    • Michael Mauro, MD