Parameters (based on factors associated with prognosis):
(1) age in months at diagnosis (poor prognosis with age >= 24 months)
(2) percent blasts (poor prognosis if high)
(3) percent normoblasts (poor prognosis if high)
(4) platelet count (poor prognosis if thrombocytopenia)
Other poor prognostic features:
(5) hepatomegaly
(6) bleeding
Interestingly (compared to 03.18.18) the authors found that fetal hemoglobin lost its significance when adjusted for age and platelet count. Other risk factors not predictive: gender, infections, cutaneous manifestations, lymphadenopathy, splenomegaly, hemoglobin level, WBC count, monocyte or immature granulocyte counts.
discriminant score =
= (0.677 * LOG10(((absolute normoblast count per L) * (10^(-9))) + 0.5)) + (0.043 * (age at diagnosis in months)) + (1.123 * LOG10(((absolute blasts count per L) * (10^(-9))) + 0.5)) - (2.847 * LOG10((platelet count per L) * (10^(-9))))
Interpretation:
• A discriminant score >= -4.2 indicates a worse prognosis group with survival <= 24 months.
• A discriminant score < -4.2 indicates a better prognosis group with survival > 24 months.
Limitations:
• The score was reported in 1984. How it corresponds with current prognosis is uncertain. It may have value as showing prognosis prior to current management methods.
