Bone Marrow Score of Wang et al for Identifying an Immunocompetent Patient with Fever of Unknown Origin (FUO) Who Should Have Bone Marrow Biopsy

Description

Wang et al reported a score for identifying an immunocompetent patient with fever of unknown origin (FUO) who should have a bone marrow biopsy. This can help to identify patients with a hematological disorder. The authors are from Taipei Veterans General Hospital and National Yang-Ming University.

Patient selection: immunocompetent patient with FUO

Outcome: early bone marrow biopsy

Parameters:

(1) absolute neutrophil count per µL

(2) hemoglobin in g/dL

(3) serum LDH

(4) platelet count per µL

(5) splenomegaly

(6) serum ferritin in ng/mL

(7) leukoerythroblastic changes in peripheral blood smear

Parameter	Finding	Points
absolute neutrophil count	>= 2,000 per µL	0
	< 2,000 pe µL	1
hemoglobin	>= 10 g/dL	0
	< 10 g/dL	1.5
serum LDH	<= ULN	0
	> ULN	1.5
platelet count	>= 100,000 per µL	0
	< 100,000 per µL	2
splenomegaly	absent	0
	present	4
serum ferritin	<= 1,000 ng/mL	0
	> 1,000 ng/mL	5.5
leukoerythroblastic changes	absent	0
	present	6

total score =

= SUM(points for all 7 parameters)

Interpretation:

• minimum score: 0

• maximum score: 21.5

• A score < 6 was not associated with a hematologic disorder.

• A score >= 6 was 77% specific for a hematologic disorder.

Performance:

• The area under the ROC curve was 0.89.

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Bone Marrow Score of Wang et al for Identifying an Immunocompetent Patient with Fever of Unknown Origin (FUO) Who Should Have Bone Marrow Biopsy

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