Itzykson et al reported a prognostic score for a patient with higher risk myelodysplasia. This can help to identify a patient who may benefit from more aggressive management. the authors are members of the Groupe Francophone des Myelodysplasies (GFM).
Patient selection: intermediate-2 and high risk myelodysplastic syndrome (MDS) according to the IPSS, treated with azacitidine (a hypomethylating agent).
Outcomes: overall survival
Parameters:
(1) WHO performance status
(2) cytogenetics according to the IPSS classification (see below)
(3) circulating blasts
(4) red blood cell transfusion requirements in 8 week period
|
Parameter |
Finding |
Points |
|
WHO performance status |
0 or 1 |
0 |
|
|
2, 3 or 4 |
1 |
|
cytogenetics |
low risk |
0 |
|
|
intermediate risk |
1 |
|
|
poor risk |
2 |
|
circulating blasts |
no |
0 |
|
|
yes |
1 |
|
RBC transfusion requirements |
< 4 units in 8 weeks |
0 |
|
|
>= 4 units in 8 weeks |
1 |
where:
• Low risk cytogenetics = normal karyotype, Y-, 5q-, or 20q-
• Poor risk cytogenetics = abnormal chromosome 7, or >= 3 chromosomal abnormalities
• Intermediate risk cytogenetics = all other cytogenetic abnormalities
total score =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the worse the survival.
|
Total Score |
Risk Group |
Median Survival |
|
0 |
low |
> 60 months |
|
1, 2 or 3 |
intermediate |
15 months |
|
4 or 5 |
high |
6 months |
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
