Parimon et al developed a Pretransplantation Assessment of Mortality (PAM) Score to evaluate a patient prior to allogeneic stem cell transplantation. The authors are from the Fred Hutchinson Cancer Research Center and Veterans Affairs Puget Sound Health Care System in Seattle, Washington.
Parameters:
(1) age of the patient in years
(2) donor type
(3) risk of underlying disease
(4) conditioning regimen
(5) serum creatinine concentration
(6) serum ALT in IU/L
(7) FEV1 as percent of predicted
(8) carbon monoxide diffusing capacity (DLCO) as percent of predicted
Underlying Disease (page 408) |
Associated Risk |
---|---|
CML in chronic phase, refractory anemia, aplastic anemia, Blackfan-Diamond Syndrome |
low risk |
CML in accelerated phase, CML in chronic phase after a blastic phase, acute leukemia in remission, malignant lymphoma in remission, refractory anemia with excess blasts, CLL, PNH |
intermediate risk |
CML in blastic phase, juvenile CML, acute leukemia, active malignant lymphoma, refractory anemia with excess blasts in transformation, myeloma, solid tumors, nonhematologic disorder |
high risk |
Parameter |
Finding |
Points |
---|---|---|
age of the patient in years |
< 50 |
1 |
|
50 to 60 |
3 |
|
> 60 |
5 |
donor type |
related, matched |
1 |
|
unrelated |
3 |
|
related, mismatch |
4 |
disease risk |
low |
1 |
|
intermediate |
8 |
|
high |
12 |
conditioning regimen |
nonmyeloablative |
1 |
|
non total body irradiation (TBI) |
4 |
|
TBI <= 12 Gy |
8 |
|
TBI > 12 Gy |
9 |
serum creatinine |
<= 1.2 mg/dL (<= 106 µmol/L) |
1 |
|
> 1.2 mg/dL (> 106 µmol/L) |
8 |
serum ALT |
<= 49 IU/L |
1 |
|
> 49 IU/L |
2 |
FEV1 |
> 80% |
1 |
|
70 - 80% |
3 |
|
< 70% |
6 |
carbon monoxide diffusing capacity |
>= 70% |
1 |
|
< 70% |
4 |
total score =
= SUM(points for all 8 conditions)
Interpretation:
• minimum score: 8
• maximum score: 50
• The higher the score the greater the risk of death after the transplant.
Total Score |
Mortality Risk |
<= 16 |
< 25% |
17 to 23 |
25 - 50% |
24 to 30 |
50 - 75% |
>= 31 |
> 75% |
Purpose: To evaluate a patient prior to allogeneic stem cell transplantation using the Pretransplantation Assessment of Mortality (PAM) score of Parimon et al.
Specialty: Clinical Laboratory, Hematology Oncology, Surgery, general
Objective: other testing, severity, prognosis, stage, selection
ICD-10: Z52,