الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Chronic myeloid leukemia (CML) is a myeloproliferative disorder characterized by the neoplastic transformation of the hematopoietic stem cell and the pathognomonic presence of the Philadelphia (Ph) chromosome. Comorbidities are known to complicate longitudinal trials in diseases with expected long OS times. The influence of comorbidities on outcome in CML patients has been rarely studied Our study conducted retrospectively on 365 CML patients from oncology center Mansura University medical records from January 2010 to July 2021. Median age of our patients was 44 years and 62.5% were males, treated with imatinib (n = 299) or a 2G-TKI (n = 66). Patients were classified at diagnosis based on Sokal, Hasford and ELTS risk score into Low/intermediate/high risk categories 106/205/54 cases, 36/108/221 cases, 139/169/23 cases respectively. And the distribution according to the EUTOS score was: 311patients in the low-risk and 54 in the high-risk group. In our study, we first assessed the ability of the four scoring systems to predict outcomes, and showed that the Sokal score was the only scoring system among the others that able to predict the MMR at any time (p <0.001), meanwhile Hasford score was significantly correlated with cumulative incidence of DMR (p 0.013). In our study, the Sokal, EUTOS and ELTS scores but not Hasford score were clinically effective prognostic indictors for CML transformation into AP or BP (p 0.012, 0.001, and 0.045 respectively). Our results showed that Sokal, EUTOS and ELTS scores were predictors for death in CML patients (P≤0.001, 0.01 and ≤0.001 respectively) Our data showed that the four scores Sokal, Hasford, EUTO and ELTS were significantly associated with the OS (Sokal, p<0.001 ; Hasford, p 0.008 ; EUTOS, p 0.007; and ELTS, p < 0.001). Also, CCI score > 2 was a predictor for worse OS with significant p <0.001. Conclusion The different prognostic systems still validate in TKIs era, the Sokal score was superior to the other scores in predicting cumulative MMR while Hasford score was superior in predicting DMR. EUTOS and Hasford scores were important predictors regarding failure of treatment and shift to 2nd line. The four risk scores and CCI score had significant role regard predicting OS.