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Acute Myeloid Leukemia or High-Risk Myelodysplasia | Risk Factors for Acute Pulmonary Failure During Chemo

Purpose: To determine the risk for acute pulmonary failure developing in a patient undergoing induction chemotherapy for AML or myelodysplasia.

Description

Al Ameri at al identified risk factors for acute pulmonary failure during remission induction chemotherapy for acute myeloid leukemia (AML) or high-risk myelodysplasia. These can help to identify a patient who may benefit from closer monitoring and preventive measures during and after therapy. The authors are from the University of Texas M.D. Anderson Cancer Center.


 

Parameters:

(1) gender

(2) diagnosis

(3) performance status

(4) chest X-ray at diagnosis

(5) serum creatinine (as a marker of renal function)

 

Parameter

Finding

Points

gender

female

0

 

male

1

diagnosis

acute promyelocytic leukemia

1

 

other

0

performance status

ECOG 0 or 1

0

 

ECOG 2 to 4

1

chest X-ray at diagnosis

no infiltrate

0

 

infiltrate

1

serum creatinine

normal

0

 

elevated (>= 1.3 mg/dL)

1

 

total score =

= SUM(points for parameter)

 

Interpretation:

• minimum number of risk factors: 0

• maximum number of risk factors: 5

• The risk for developing acute pulmonary failure increases with the number of risk factors present.

 

Differential diagnosis of acute pulmonary failure during induction chemotherapy:

(1) pulmonary hemorrhage

(2) capillary leak syndrome

(3) pneumonia

(4) sepsis

(5) fluid overload

 


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Specialty

Objective

ICD-10