A patient with CMML may undergo hematopoietic stem cell transplantation (HSCT). Gagelmann et al reported a score which can help to identify a patient who may require more aggressive management. The authors are from multiple institutions in Germany, the United States and France.
Patient selection: CMML
Parameters:
(1) Hematopoietic Cell Transplantation Comorbidity Index of Sorror et al, from 0 to 26
(2) percent bone marrow blasts
(3) ASXL-1 and/or NRAS mutations
Parameter
Finding
Points
HCT-CI of Sorror et al
percent blasts
<= 2
0
> 2
4
mutations in ASXL-1 or NRAS
neither
0
one or both
4
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 34 (20 was maximum seen in study)
Score
Group
5-Year Mortality Risk
0 or 1
1
19%
2 to 4
2
51%
5 to 7
3
57%
8 to 10
4 (moderate to high)
69%
>= 11
5 (high risk)
81%
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