The Italian Cooperative Study Group on Chronic Myeloid Leukemia developed a staging system based on the number of negative prognostic factors present for a patient.
Parameters used for score, using findings present at the time of diagnosis:
(1) spleen size in anterior axillary line
(2) liver size in midclavicular line
(3) platelet count
(4) WBC count
(5) circulating blasts
(6) circulating immature granulocyte precursors
|
Parameter |
Finding |
Points |
|
spleen size |
impalpable or < 15 cm below costal margin |
0 |
|
|
>= 15 cm below costal margin |
1 |
|
liver size |
impalpable or < 6 cm below costal margin |
0 |
|
|
>= 6 cm below costal margin |
1 |
|
platelet count |
< 150,000 per µL (150 * 10^9/L) |
1 |
|
|
150,000 – 500,000 per µL |
0 |
|
|
> 500,000 per µL (500 * 10^9/L) |
1 |
|
WBC count |
< 100,000 per µL (100 * 10^9/L) |
0 |
|
|
>= 100,000 per µL |
1 |
|
circulating blasts in peripheral blood |
< 1% |
0 |
|
|
>= 1% |
1 |
|
circulating immature granulocyte precursors |
< 20% |
0 |
|
|
>= 20% |
1 |
where:
• Circulating blasts = all forms (myeloblasts, monoblasts, etc.)
• Immature granulocyte precursors = myeloblasts, promyelocytes, and myelocytes (page 108)
number of negative prognostic factors =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• A higher score is associated with a worse prognosis.
|
Score |
Group |
Median Survival |
6 Year Survival |
|
0 or 1 |
I |
68 months |
43% |
|
2 or 3 |
II |
46 months |
26% |
|
4, 5 or 6 |
III |
28 months |
8% |
Limitations:
• The scale was formulated in 1981. Additional prognostic factors are now available and newer therapies have improved survival.
Specialty: Hematology Oncology
ICD-10: ,
