# Sokal index

Sokal index

Status: LIVE
Price: $0.005 USDC
`GET /api/calc/sokal`
HTML: https://magentlab.com/docs/sokal
Markdown: https://magentlab.com/docs/sokal.md

Not a medical device. Not a diagnosis, dose, or listing recommendation.

## What it computes

Compute the Sokal 1984 relative-risk index for newly diagnosed untreated chronic granulocytic leukemia from age, spleen size below the costal margin, platelet count, and percent circulating blasts, with the paper’s three groups.

## When to use

When an agent needs the published Sokal 1984 index and must not invent later CML scores, diagnose CML, or choose TKI therapy.

## When not to use

- Not a medical device. magent does not diagnose CML.
- Sokal 1984 applies to newly diagnosed untreated chronic granulocytic leukemia (CML) only.
- Does not choose TKI therapy or any other treatment.

## Formula

```
sokal_index = exp(0.0116 * (age - 43.4) + 0.0345 * (spleen_cm - 7.51) + 0.188 * ((platelets_10e9_l / 700) ^ 2 - 0.563) + 0.0887 * (blasts_percent - 2.10))
```

## Citation

[Prognostic discrimination in "good-risk" chronic granulocytic leukemia](https://doi.org/10.1182/blood.V63.4.789.789)
Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE, Tso CY, Braun TJ, Clarkson BD, Cervantes F, Rozman C
Blood. 1984;63(4):789-799
DOI: [10.1182/blood.V63.4.789.789](https://doi.org/10.1182/blood.V63.4.789.789)

## Worked example

### Age 50, spleen 10 cm, platelets 350 ×10⁹/L, blasts 2%

Given: `age=50, blasts_percent=2, platelets_10e9_l=350, spleen_cm=10`

1. 0.0116 × (50 − 43.4) = 0.07656
2. 0.0345 × (10 − 7.51) = 0.085905
3. 0.188 × ((350 / 700) ^ 2 − 0.563) = 0.188 × (0.25 − 0.563) = −0.058844
4. 0.0887 × (2 − 2.10) = −0.00887
5. sokal_index = exp(0.094751) ≈ 1.10
6. 0.8 ≤ 1.10 ≤ 1.2 → intermediate


### Age 40, spleen 5 cm, platelets 250 ×10⁹/L, blasts 1%

Given: `age=40, blasts_percent=1, platelets_10e9_l=250, spleen_cm=5`

1. sokal_index ≈ 0.74
2. 0.74 < 0.8 → low


### Age 60, spleen 15 cm, platelets 700 ×10⁹/L, blasts 5%

Given: `age=60, blasts_percent=5, platelets_10e9_l=700, spleen_cm=15`

1. sokal_index ≈ 2.20
2. 2.20 > 1.2 → high


## Also searched as

- Sokal index
- Sokal score
- CML Sokal
- chronic granulocytic leukemia Sokal
- Sokal 1984
- CML prognostic index
- Sokal hazard ratio

## Parameters

- `age` (integer, required): Age in years (integer 1-120). Sokal 1984 CML index; not the adult 18-120 clamp.
- `spleen_cm` (number, required): Spleen size in cm below the costal margin (0-40). Sokal 1984.
- `platelets_10e9_l` (number, required): Platelet count ×10⁹/L (1-5000). Sokal 1984; CML counts may exceed 2000.
- `blasts_percent` (number, required): Circulating blasts as a percent of leukocytes (0-100). Sokal 1984.

## Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

Method: `POST /api/calc/sokal`
Max items: 25
Price: unit_amount + extra_item_amount * (n - 1) (unit 5000 atomic, extra 2000 atomic)
Status: PREVIEW

- 1 to 25 items. Each item uses the same keys as the GET query parameters.
- POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
- The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
- HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
- Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
- x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request:

```json
{
  "items": [
    {
      "age": "50",
      "blasts_percent": "2",
      "platelets_10e9_l": "350",
      "spleen_cm": "10"
    },
    {
      "age": "50",
      "blasts_percent": "2",
      "platelets_10e9_l": "350",
      "spleen_cm": "10"
    }
  ]
}
```

Human paywall (two-item fixture): https://api.magentlab.com/paywall/bulk/sokal

Example 200:

```json
{
  "count": 2,
  "path": "/api/calc/sokal",
  "items": [
    {
      "age": 50,
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE, Tso CY, Braun TJ, Clarkson BD, Cervantes F, Rozman C",
        "doi": "10.1182/blood.V63.4.789.789",
        "id": "sokal-1984",
        "pmid": "6584184",
        "source": "Blood. 1984;63(4):789-799",
        "title": "Prognostic discrimination in \"good-risk\" chronic granulocytic leukemia"
      },
      "formula": "sokal",
      "formula_expression": "sokal_index = exp(0.0116 * (age - 43.4) + 0.0345 * (spleen_cm - 7.51) + 0.188 * ((platelets_10e9_l / 700) ^ 2 - 0.563) + 0.0887 * (blasts_percent - 2.10))",
      "platelets_10e9_l": 350.0,
      "spleen_cm": 10.0,
      "blasts_percent": 2.0,
      "sokal_band": "intermediate",
      "sokal_index": 1.1
    },
    {
      "age": 50,
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE, Tso CY, Braun TJ, Clarkson BD, Cervantes F, Rozman C",
        "doi": "10.1182/blood.V63.4.789.789",
        "id": "sokal-1984",
        "pmid": "6584184",
        "source": "Blood. 1984;63(4):789-799",
        "title": "Prognostic discrimination in \"good-risk\" chronic granulocytic leukemia"
      },
      "formula": "sokal",
      "formula_expression": "sokal_index = exp(0.0116 * (age - 43.4) + 0.0345 * (spleen_cm - 7.51) + 0.188 * ((platelets_10e9_l / 700) ^ 2 - 0.563) + 0.0887 * (blasts_percent - 2.10))",
      "platelets_10e9_l": 350.0,
      "spleen_cm": 10.0,
      "blasts_percent": 2.0,
      "sokal_band": "intermediate",
      "sokal_index": 1.1
    }
  ]
}
```

## Response fields

- `formula` (string): sokal
- `formula_expression` (string): Exact expression used
- `age` (integer): Age in years used
- `spleen_cm` (number): Spleen size used, cm below the costal margin
- `platelets_10e9_l` (number): Platelet count used, ×10⁹/L
- `blasts_percent` (number): Circulating blasts used, percent of leukocytes
- `sokal_index` (number): Sokal 1984 relative-risk index, 2 decimals
- `sokal_band` (string): Sokal 1984 three groups: low (index < 0.8), intermediate (0.8 ≤ index ≤ 1.2), high (index > 1.2). Not a diagnosis and not a TKI choice.
- `citation` (object): Sokal 1984 Blood citation
- `disclaimer` (string): Not-a-device notice

## Example JSON

Frozen fixture. Not a live lookup.

```json
{
  "age": 50,
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Sokal JE, Cox EB, Baccarani M, Tura S, Gomez GA, Robertson JE, Tso CY, Braun TJ, Clarkson BD, Cervantes F, Rozman C",
    "doi": "10.1182/blood.V63.4.789.789",
    "id": "sokal-1984",
    "pmid": "6584184",
    "source": "Blood. 1984;63(4):789-799",
    "title": "Prognostic discrimination in \"good-risk\" chronic granulocytic leukemia"
  },
  "formula": "sokal",
  "formula_expression": "sokal_index = exp(0.0116 * (age - 43.4) + 0.0345 * (spleen_cm - 7.51) + 0.188 * ((platelets_10e9_l / 700) ^ 2 - 0.563) + 0.0887 * (blasts_percent - 2.10))",
  "platelets_10e9_l": 350.0,
  "spleen_cm": 10.0,
  "blasts_percent": 2.0,
  "sokal_band": "intermediate",
  "sokal_index": 1.1
}
```

## Errors

- HTTP 400 `invalid_sokal_age`: age must be an integer from 1 to 120 (Sokal 1984; CML index, not the adult 18-120 clamp). Returned before settlement; you are not charged.
- HTTP 400 `invalid_spleen_cm`: spleen_cm must be a number from 0 to 40 (cm below the costal margin; Sokal 1984). Returned before settlement; you are not charged.
- HTTP 400 `invalid_sokal_platelets`: platelets_10e9_l must be a number from 1 to 5000 (Sokal 1984; CML counts may exceed 2000). Returned before settlement; you are not charged.
- HTTP 400 `invalid_blast_percent`: blasts_percent must be a number from 0 to 100 (Sokal 1984). Returned before settlement; you are not charged.
- HTTP 400 `invalid_items`: POST body must be a JSON object with only an items array Returned before settlement; you are not charged.
- HTTP 400 `invalid_item_count`: items must be an array of 1 to 25 objects Returned before settlement; you are not charged.
- HTTP 400 `invalid_item`: each items entry must be a JSON object Returned before settlement; you are not charged.

Shared HTTP 402 and 503: https://magentlab.com/docs/payments

## Related tools

- [ANC](https://magentlab.com/docs/anc) — Compute absolute neutrophil count from WBC and neutrophil plus band percents, plus a Bodey 1966 granulocyte band.
- [NLR](https://magentlab.com/docs/nlr) — Compute the Zahorec 2001 neutrophil-to-lymphocyte ratio from relative neutrophil and lymphocyte percents.
- [Mentzer index](https://magentlab.com/docs/mentzer) — Compute the Mentzer 1973 index as mean corpuscular volume in fL divided by red-cell count in millions per µL, with the letter’s <13 / >13 / =13 bands.

## Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s.

- GET the tool with Accept: application/json (do not send Accept: text/html unless you want the human paywall).
- HTTP 402 means you have not paid. Decode the base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote.
- Sign accepts[0] (exact, EIP-3009) with validBefore = now + maxTimeoutSeconds (600 seconds), or accepts[1] (batch-settlement deposit/voucher) on product GET. Ping and POST {items} stay exact. Magent retries transient facilitator 429/5xx before answering.
- Retry the same URL with PAYMENT-SIGNATURE (base64 JSON of accepted and payload). Magent attaches canonical extensions.bazaar on CDP verify/settle; echoing 402 bazaar is optional.
- Success is HTTP 200 JSON plus PAYMENT-RESPONSE. exact settles before the tool. batch-settlement verifies (and deposit-settles) before the tool and commits the charge after HTTP 2xx. HTTP 503: retry the same PAYMENT-SIGNATURE. Mint a new exact nonce only after a new HTTP 402.

- offered `exact` on eip155:8453: Fixed-price USDC on Base. The buyer authorizes the advertised amount (EIP-3009). magent settles before the tool runs (paymentFlow upfront). extra.assetTransferMethod=eip3009 extra.paymentFlow=upfront.
- offered `batch-settlement` on eip155:8453: Payment-channel vouchers claimed later in batches. Exact stays accepts[0]. Same-path POST {items} is still exact. extra.assetTransferMethod=eip3009 extra.paymentFlow=authorization.

- not offered `upto`: Not offered. Usage-based: buyer authorizes a ceiling, seller settles the actual amount after work. Reserved for a future metered tool. Not for current calculators or code search.

Same-path POST {items} is still scheme exact: one EIP-3009 authorization for GET unit plus $0.002 per extra item. That is not x402 batch-settlement (payment channels / vouchers).

Shared HTTP 402 and 503 table: https://magentlab.com/docs/payments

Stdio MCP (one process per host): https://magentlab.com/docs/mcp

## Guarantees

- HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged.
- exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
- HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
- Execution is timeout-bounded and concurrency-capped.
- Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.