Patient selection: myelodysplastic syndrome with low or intermediate risk based on the International Prognostic Scoring System (value <= 2)
A major response to darbepoietin alpha was either an increase in hemoglobin > 2 g/dL and/or termination of the need for red blood cell transfusions.
Parameters:
(1) baseline serum levels of endogenous erythropoietin in IU/L
(2) transfusion needs per month
(3) blasts in the bone marrow
(4) cellularity of bone marrow
|
Parameter
|
Finding
|
Points
|
|
serum levels of endogenous erythropoietin
|
>= 100 IU/L
|
0
|
|
|
< 100 IU/L
|
1
|
|
transfusion needs
|
> 2 units per month
|
0
|
|
|
0 - 2 units per month
|
1
|
|
blasts in bone marrow
|
normal
|
1
|
|
|
excess
|
0
|
|
cellularity of bone marrow
|
hyperplastic
|
0
|
|
|
normocellular
|
0
|
|
|
hypoplastic
|
1
|
where:
• The p value for marrow hypoplasia was not significant while the other factors had low p values. Only 6 of the 37 patients studied had a hypoplastic marrow.
number of factors associated with response =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number of factors: 0
• maximum number of factors: 4
• A person with 0 factors will probably not respond to therapy.
