Risk Stratification of Chronic Myeloid Leukemia in Family Medicine Practice, Taking Into Account Comorbidity

Chronic myeloid leukemia (CML) is a clonal myeloproliferative disorder that arises from a translocation between chromosomes 9 and 22 and the formation of the oncogenic BCR-ABL gene. With the introduction of tyrosine kinase inhibitors (TKIs), CML therapy has undergone a transformation, significantly prolonging the life expectancy of patients. As a result, the proportion of patients with long-term disease and concomitant chronic conditions has increased, and with it the need for interdisciplinary management, especially at the primary care level.The article highlights the current aspects of risk stratification for CML progression, which is an important part of the clinical pathway for patients, particularly for family doctors. The main prognostic scales — Sokal, Hasford (Euro), EUTOS, and ELTS — are described, with an explanation of their structure, components, and clinical significance. Their role is revealed not only in risk assessment but also in the selection of first-line ITC and prediction of remission duration. It is explained why, even without direct calculation of the scales, family doctors should be familiar with their logic for informed communication with patients and specialists.Special attention is paid to multimorbidity, which largely determines the clinical prognosis, although it is not formally taken into account in existing scales. Examples of clinical situations illustrate how the presence of cardiovascular, metabolic, or renal pathologies can affect patient management, including the choice of ITC, the need for more frequent monitoring, or a change in treatment priorities. The importance of the family doctor in the timely identification of high-risk patients and the justification of urgent referral is emphasized.The material provides an instructional basis for the practical use of stratification approaches in CML in family medicine, contributing to more accurate prognosis and individualization of therapy.