When we see a patient for the first time, we want to calculate the Sokal score to determine how aggressive this patient’s disease is going to be. The NCCN Guidelines suggest that those patients with intermediate- or high-risk Sokal scores may have less response to TKI therapies, and therefore, we may want to use a second-generation as our initial treatment. The Sokal score developed in the interferon era predicted survival, but now in the TKI era, it predicts response but not survival. So, what is in the Sokal score? Higher age, higher platelet count, bigger spleen, and circulating peripheral blasts, so when I see a patient with any of these four characteristics, I get more nervous and I tend to treat them with a more aggressive initial therapy, and I watch them very carefully.For more information on managing your patients with CML, and to participate in an interactive case study in which you’ll be able to make clinical decisions for a patient with CP-CML, please view the activity available here.