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Clinical calculator summary

Original EUTOS Long-Term Survival score

A four-variable baseline prognostic equation for CML-related death in chronic-phase CML.

Evidence-based context for fast calculator use

Purpose:
Reproduce the original four-decimal ELTS score and source-defined low, intermediate, or high group.
Population:
Adults with newly diagnosed chronic-phase Ph-positive and/or BCR::ABL1-positive CML before treatment.
Factors:
Completed age, Palpable spleen size, Peripheral-blood blasts, Platelet count
Reference:
Pfirrmann et al. Leukemia. 2016;30:48-56. doi:10.1038/leu.2015.261.
HomeELTS Score (CML)
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ELTS Score (CML)

years
cm
%
x10⁹/L

Clinical Context & Background

This page implements the original EUTOS Long-Term Survival (ELTS) score for baseline prognosis in adults with newly diagnosed chronic-phase, Philadelphia chromosome-positive and/or BCR::ABL1-positive chronic myeloid leukemia before CML therapy.
Enter completed age, palpable spleen size in centimetres below the costal margin, peripheral-blood blasts rounded to an integer percentage, and platelet count in x10^9/L. The equation is calculated at full precision, the final score is rounded to four decimal places, and the risk group is assigned from that four-decimal value, matching the official ELN operational calculator.
ELTS estimates a group-level risk of CML-related death. It is not an on-treatment molecular-response score or a blast-phase model, and it is not a treatment-selection algorithm. After treatment starts, use serial BCR::ABL1 molecular monitoring and current guidance rather than recalculating ELTS.
Primary Source EvidencePfirrmann M, et al. Leukemia. 2016;30(1):48-56. doi:10.1038/leu.2015.261.
Formula Logic
ELTS = 0.0025 x (age / 10)^3 + 0.0615 x spleen + 0.1052 x blasts + 0.4104 x (platelets / 1000)^-0.5

Reference Data

Risk GroupFour-decimal ELTS scoreInterpretation
Low Risk<= 1.5680Lower source-defined group for CML-related death
Intermediate Risk> 1.5680 and <= 2.2185Intermediate source-defined group
High Risk> 2.2185Higher source-defined group

Clinical Workflow

Use, Interpret, And Continue The Patient Pathway

Expand for workflow guidance, limitations, examples, and related next steps.

When To Use

  • Use once at diagnosis for an adult with newly diagnosed chronic-phase Ph-positive and/or BCR::ABL1-positive CML, before CML treatment starts.
  • Use palpable spleen size in cm below the costal margin, integer peripheral-blood blast percentage, and platelets in x10^9/L.

How To Interpret

  • The calculator rounds the full-precision equation result to four decimals, then applies the published cutoffs.
  • The categories concern CML-related death and are not individualized absolute probabilities.

What To Do Next

  • Document all four baseline variables, the four-decimal score, risk group, and any derivation-range warning.
  • After treatment begins, follow serial BCR::ABL1 molecular milestones and current CML guidance rather than recalculating ELTS.

Limitations

  • Not intended for post-treatment values, accelerated/blast phase, molecular milestone assessment, or treatment selection by itself.
  • The original derivation was imatinib-centric and omitted additional cytogenetic abnormalities, somatic mutations, comorbidity, adherence, and treatment toxicity.
  • Values outside age 18-88 years, spleen 0-38 cm, blasts 0-14%, or platelets 34-4920 x10^9/L receive an applicability warning rather than an invented hard limit.

Validated Population

Original adult newly diagnosed chronic-phase CML cohorts assessed before therapy; strongest evidence for b2a2 and/or b3a2 transcripts and imatinib-based treatment.

Four-decimal classification

Age 50, spleen 2 cm, blasts 1%, and platelets 300 x10^9/L produces 1.2900 (Low Risk).

Hematology calculatorsReview other hematology tools without combining their outputs with ELTS.

Calculation verification history

Verified

  1. : Production browser revalidation

    • Three source-backed cases passed through visible production controls at ELTS 1.2900, 1.8872, and 3.9113.
    • Low, Intermediate, and High groups rendered as expected.
    • No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
    Download latest production check (Excel)

    Case-level evidence is retained in validation/browser-revalidation/lymphoma-elts-score-2026-08-03.json.

  2. : Production browser validation

    • Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
    • Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
    • Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.

    Case-level production evidence is retained in validation/browser-production/lymphoma-elts-score.json.

  3. : Full validation test

    • Verified the original four-term equation, all four input contracts, representative and cutoff-rounding fixtures, derivation warnings, malformed-input rejection, monotonic properties, full-precision trace, public display, and evidence wiring.

  4. : Correction history

    • Changed risk assignment to use the official four-decimal rounded score, preserved trailing zeros and the raw score, rejected missing and malformed inputs, added source-range warnings, corrected CML discovery placement, and clarified baseline chronic-phase use without treatment-selection or molecular-monitoring claims.

Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.

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Frequently Asked Questions

When should ELTS be calculated?

At baseline before CML therapy in adults with newly diagnosed chronic-phase Ph-positive and/or BCR::ABL1-positive CML.

How are the cutoffs applied?

The full-precision equation result is rounded to four decimal places first. Low is <=1.5680, intermediate is >1.5680 to <=2.2185, and high is >2.2185.

Can ELTS replace molecular monitoring?

No. ELTS is a baseline prognostic score. After treatment starts, serial BCR::ABL1 monitoring and current CML guidance determine response assessment.

Evidence-based oncology decision support. Verify with clinical guidelines.