Dippel et al reported the CTCL Severity Index for evaluating a patient with a cutaneous T-cell lymphoma (CTCL). The authors are from the Free University of Berlin.
Patient selection: cutaneous T-cell lymphoma (CTCL)
Parameters:
(1) percent of body surface area (BSA) involved
(2) number of tumors
(3) lymph nodes
(4) atypical lymphoid cells in the peripheral blood, per microliter
(5) viscera (liver, spleen, etc)
|
Parameter
|
Finding
|
Points
|
|
percent of BSA involved
|
0%
|
0
|
|
|
1-10%
|
3
|
|
|
11-20%
|
6
|
|
|
21-40%
|
9
|
|
|
41-60%
|
12
|
|
|
suberythrodermic
|
14
|
|
|
erythrodermic
|
15
|
|
number of tumors
|
0
|
0
|
|
|
1
|
6
|
|
|
2 to 10
|
8
|
|
|
> 10
|
10
|
|
lymph nodes
|
normal
|
0
|
|
|
nonspecific enlargement
|
5
|
|
|
specific enlargement
|
10
|
|
atypical cells in blood
|
0 to 99 per microliter
|
0
|
|
|
100 to 1,000 per µL
|
5
|
|
|
> 1,000 per µL
|
10
|
|
viscera
|
normal
|
0
|
|
|
1 organ affected
|
15
|
|
|
>= 2 organs affected
|
25
|
|
|
Sezary syndrome
|
25
|
where:
• Sezary syndrome is defined as erythroderma AND > 1,000 Sezary cells per µL in the blood.
severity index =
= SUM(points for all of the parameters)
Interpretation:
• minimum severity index: 0
• maximum severity index: 70
• The higher the index the greater the severity.
SR5 equation for 5-year survival in percent for patients with a severity index of 22 to 62 =
= 124 - (2 * (severity index))
Evans et al (2011) found that the SR5 equation did not have significant predictive value.
