CML chronic phase with Hasford (EURO) high risk — supports 2nd-generation TKI 1L (dasatin...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

ID	`RF-HASFORD-HIGH`
Type	Red flag
Status	reviewed 2026-04-27 \| pending_clinical_signoff
Diseases	`DIS-CML`
Sources	`SRC-ELN-CML-2020` `SRC-ESMO-CML-2017` `SRC-NCCN-MPN-2025`

Red Flag Origin

Definition	CML chronic phase with Hasford (EURO) high risk — supports 2nd-generation TKI 1L (dasatinib / nilotinib / bosutinib) over imatinib; comparable rationale to Sokal-high
Clinical direction	intensify
Category	risk-score
Shifts algorithm	ALGO-CML-1L

Trigger Logic

{
  "any_of": [
    {
      "finding": "cml_hasford_risk",
      "value": "high"
    },
    {
      "finding": "cml_euro_risk",
      "value": "high"
    },
    {
      "comparator": ">",
      "finding": "cml_hasford_score",
      "threshold": 1480
    }
  ],
  "type": "composite_score"
}

Notes

Hasford / EURO score (Hasford 1998) refined Sokal by adding eosinophils and basophils; high-risk = >1480. Hasford-high and Sokal-high overlap substantially but identify slightly different subsets. ELN 2020 recognizes both alongside the newer ELTS but prefers ELTS for treatment-free remission planning. Direction `intensify` to 2nd-gen TKI 1L; co-fires with RF-SOKAL-HIGH and the existing RF-CML-HIGH-RISK-ELTS. The CML-1L algorithm picks the 2nd-gen track as long as comorbidity flags don't de-escalate.

Used By

Algorithms

ALGO-CML-1L - ALGO-CML-1L

Red flag

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