Risk Score of Gatto et al for a Patient with the Myelodysplastic Syndrome (MDS)

Description

Gatto et al developed a simple risk score using beta-2 microglobulin to evaluate prognosis in patients with a myelodysplastic syndrome. This can help identify patients who may benefit from more aggressive management or novel therapies. The authors are from the M.D. Anderson Cancer Center and the Methodist Hospital in Houston, Texas.

Patient exclusions:

(1) serum creatinine > 1.5 mg/dL (beta-2 microglobulin increased with impaired renal function)

(2) CMML with white blood cell count > 12,000 per µL (excluded in the IPSS)

Parameters:

(1) karyotype on bone marrow chromosome studies using the IPSS criteria

(2) beta-2 microglobulin (B2M) concentration

(3) platelet count and hemoglobin (presence of anemia and thrombocytopenia)

(4) percent blasts in the bone marrow

Parameter	Finding	Points
karyotype	good or intermediate	0
	poor	9
beta-2 microglobulin	<= 2 mg/L	0
	> 2 mg/L	6
platelet count and hemoglobin	platelet count < 100,000 per µL AND hemoglobin < 10 g/dL	3
	platelet count >= 100,000 per µL OR hemoglobin >= 10 g/dL	0
percent bone marrow blasts	0 to 4 percent	0
	>= 5 percent	2

where:

• The IPSS is described in 03.18.09 (above). A poor karyotype is one that has an abnormal chromosome 7 or >= 3 chromosomal abnormalities. Any other pattern is good or intermediate.

total risk score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the score the worse the survival.

Risk Score	Survival
0 to 6	good
7 to 11	intermediate
12 to 20	poor

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Description

Specialty

ICD-10