Moreau et al identified clinical conditions associated with poor survival and response after high dose chemotherapy followed by autologous stem cell transplantation for systemic AL amyloidosis. These can help identify patients for whom stem cell transplantation may be hazardous. The authors are from CHU Hotel-Dieu in Nantes, France.
Parameters:
(1) creatinine clearance in mL/min (not adjusted for body surface area)
(2) nephrotic syndrome
(3) congestive heart failure
(4) neuropathy
(5) hepatomegaly
|
Parameter |
Finding |
Points |
|
creatinine clearance |
>= 30 mL/min |
0 |
|
|
< 30 mL/min |
1 |
|
nephrotic syndrome |
absent |
0 |
|
|
present with 24 hour urine protein excretion <= 3000 mg |
0 |
|
|
present with 24 hour urine protein excretion > 3000 mg |
1 |
|
congestive heart failure |
absent |
0 |
|
|
present |
1 |
|
neuropathy |
absent |
0 |
|
|
present |
1 |
|
hepatomegaly |
absent |
0 |
|
|
present with serum alkaline phosphatase <= 200 IU/L |
0 |
|
|
present with serum alkaline phosphatase > 200 IU/L |
1 |
total number of poor prognostic features =
= SUM(points for the 5 parameters)
Interpretation:
• total number of poor prognostic features: 0
• total number of poor prognostic features: 5
|
Total Number of Poor Prognostic Factors |
4 Year Overall Survival |
4 Year Event Free Survival |
|
0 or 1 |
91.7% |
46.3% |
|
>= 2 |
11.1% |
11.1% |
Limitations:
• The method and reference range for serum alkaline phosphatase was not stated.
Specialty: Hematology Oncology, Surgery, general
