Della Porta et al developed a myelodysplastic syndrome specific comorbidity index (MDS-CI). This can help to determine the risk for a non-leukemic death (NLD). The authors are from the University of Pavia & Fondazione IRCCS Policlinico San Matteo and Heinrich Heine University in Dusseldorf.
Parameters (after Sorror et al, see HCT-CI above):
(1) cardiac disease (arrhythmia, valve disease, cornary artery disease, myocardial infarction, congestive heart failure, ejection fraction <= 50%)
(2) hepatic disease (moderate or severe if cirrhosis, fibrosis, persistent total bilirubin > 1.5 times the upper limit of normal, transaminases > 2.5 times upper limit of normal)
(3) pulmonary disease (severe if FEV1 <= 65% of predicted, DLco <= 65% of predicted, dyspnea at rest, need for supplemental oxygen)
(4) renal disease (persistent serum creatinine > 2 mg/dL, renal dialysis, renal transplant)
(5) solid tumor (excluding non-melanoma skin cancer)
|
Parameter
|
Finding
|
Points
|
|
cardiac disease
|
absent
|
0
|
|
|
present
|
2
|
|
hepatic disease
|
none or mild
|
0
|
|
|
moderate or severe
|
1
|
|
pulmonary disease
|
none to moderate
|
0
|
|
|
severe
|
1
|
|
renal disease
|
absent
|
0
|
|
|
present
|
1
|
|
solid tumor
|
absent
|
0
|
|
|
present
|
1
|
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the level of comorbidity.
|
Total Score
|
Risk of Non-Leukemic Death
|
|
0
|
low
|
|
1 or 2
|
intermediate
|
|
3 to 6
|
high
|
