Estey et al developed a model for predicting survival of induction therapy given to a patient with newly diagnosed acute myeloblastic leukemia (AML). This can help identify a patient who may benefit from more aggressive management or a novel therapy. The authors are from M.D. Anderson Cancer Center in Houston.
Parameters:
(1) ECOG performance status
(2) serum total bilirubin in mg/dL
(3) age in years
(4) absolute neutrophil count per µL
(5) plasma fibrinogen in mg/dL
(6) serum albumin in g/dL
(7) hemoglobin in g/dL
(8) serum creatinine in mg/dL
|
Parameter |
Finding |
Points |
|
ECOG performance status |
0, 1 or 2 |
1 |
|
|
3 or 4 |
2 |
|
serum total bilirubin |
< 0.6 mg/dL |
1 |
|
|
0.6 - 0.9 mg/dL |
2 |
|
|
>= 1.0 mg/dL |
3 |
|
age in years |
< 50 years of age |
1 |
|
|
50 - 64 years of age |
2 |
|
|
>= 65 years of age |
3 |
|
absolute neutrophil count |
< 1,000 per µL |
1 |
|
|
>= 1,000 per µL |
2 |
|
plasma fibrinogen |
<= 200 mg/dL |
1 |
|
|
> 200 mg/dL |
2 |
|
serum albumin |
< 3.2 g/dL |
1 |
|
|
3.2 - 3.4 g/dL |
2 |
|
|
>= 3.5 g/dL |
3 |
|
hemoglobin |
< 8.0 g/dL |
1 |
|
|
>= 8.0 g/dL |
2 |
|
serum creatinine |
< 1.1 mg/dL |
1 |
|
|
1.1 - 1.3 mg/dL |
2 |
|
|
>= 1.4 mg/dL |
3 |
where:
• The units given in Table 2 for serum albumin is mg/dL when it should be g/dL.
X =
= (-1.21 * (points for performance status)) - (0.76 * (points for bilirubin)) - (0.79 * (points for age)) + (1.45 * (points for neutrophil count)) + (1.39 * (points for fibrinogen)) + (0.61 * (points for albumin)) + (1.13 * (points for hemoglobin)) - (0.57 * (points for serum creatinine)) - 0.97
probability of survival at 4 weeks after starting induction therapy =
= 1 / (1 + EXP((-1) * X))
Limitation:
• The paper was published in 1989 and therapy has change since then.
Specialty: Hematology Oncology
