Vassilakopoulos et al developed a prediction rule for predicting bone marrow involvement (or perhaps better said a positive bone marrow biopsy) in a patient with Hodgkin's disease. This can help determine if a bone marrow biopsy should be done or not. The authors are from the University of Athens and several hospitals in Greece.
Parameters:
(1) presence or absence of B symptoms
(2) clinical stage
(3) anemia
(4) white blood cell (WBC) count
(5) age
(6) involvement of iliac and/or inguinal lymph nodes
|
Parameter |
Finding |
Points |
|
B symptoms |
absent |
0 |
|
|
present |
8 |
|
clinical stage |
I or II |
0 |
|
|
III or IV |
6 |
|
anemia |
absent |
0 |
|
|
present |
5 |
|
white blood cell count |
>= 6,000 per µL |
0 |
|
|
< 6,000 per µL |
5 |
|
age |
< 35 years of age |
0 |
|
|
>= 35 years of age |
3 |
|
iliac and/or inguinal lymph node involvement |
absent |
0 |
|
|
present |
3 |
total score =
= SUM(points for all 6 parameters) - 8
Interpretation:
• minimum score: -8
• maximum score: 22
• The higher the score the greater the risk of bone marrow involvement.
|
Total Score |
Risk of Bone Marrow Involvement |
Approach |
|
-1 to -8 |
0.3% |
no bone marrow biopsy |
|
0 to 9 |
4% |
unilateral BM biopsy |
|
10 to 22 |
26% |
bilateral BM biopsy |
Specialty: Hematology Oncology
