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CML chronic phase with Sokal high risk — supports 2nd-generation TKI 1L (dasatinib / nilo...

Vue déterministe de l'entité source de la LJAM. L'autorité clinique demeure avec les ID de la source cités et l'état d'approbation de l ́examinateur.

IDRF-SOKAL-HIGH
TypeSignal d’alerte
Étatreviewed 2026-04-27 | pending_clinical_signoff
MaladiesDIS-CML
SourcesSRC-ELN-CML-2020 SRC-ESMO-CML-2017 SRC-NCCN-MPN-2025

Origine du drapeau rouge

DéfinitionCML chronic phase with Sokal high risk — supports 2nd-generation TKI 1L (dasatinib / nilotinib / bosutinib) over imatinib for faster MMR/MR4.5 and improved long-term cumulative incidence of progression
Direction cliniqueintensifier
Catégoriescore de risque
Algorithme de décalageALGO-CML-1L

Logique de déclenchement

{
  "any_of": [
    {
      "finding": "cml_sokal_risk",
      "value": "high"
    },
    {
      "comparator": ">",
      "finding": "cml_sokal_score",
      "threshold": 1.2
    }
  ],
  "type": "composite_score"
}

Notes

Sokal score (Sokal 1984) uses age, spleen size, platelet count, blast %. High-risk (Sokal >1.2) marks ~20-25% of CML-CP at diagnosis with worse 10-yr OS and PFS on imatinib vs intermediate/low. ENESTnd (Saglio 2010) and DASISION (Kantarjian 2010) show 2nd-gen TKIs achieve faster + deeper molecular responses than imatinib in high-Sokal subgroups. ELN 2020 prefers ELTS (RF-CML-HIGH-RISK-ELTS, existing) but Sokal remains the more widely-used bedside score. Companion to RF-HASFORD-HIGH; both can fire together. Conflict- resolution: this RF intensifies toward 2nd-gen TKI; cardiotoxicity flags (RF-CML-COMORBIDITY-COMPLEX) may de-escalate back to imatinib.

Utilisé par

Algorithmes

Signal d’alerte