O'Brien et al identified prognostic factors for an adult with acute lymphocytic leukemia (ALL) following second salvage therapy. In general the prognosis for this population is poor. The authors are from the University of Texas M.D. Anderson Cancer Center in Houston.
Parameters:
(1) duration of first complete remission (CR) in months
(2) percent blasts in the bone marrow
(3) platelet count
(4) serum albumin in g/dL
Parameter
Finding
Points
duration of first CR
>=36 months
0
< 36 months
1
percent bone marrow blasts
<= 50%
0
> 50%
1
platelet count
> 50,000 per µL
0
<= 50,000 per µL
1
serum albumin
>= 3 g/dL
0
< 3 g/dL
1
number of adverse prognostic factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum number: 0
• maximum number: 4
• The prognosis gets worse as the number of risk factors increase.
• A patient who has had a complete response at 6 weeks after the second salvage regimen had a better prognosis than someone who did not.
Adverse Factors
1 Year Survival
0 or 1
33%
2
14%
3
8%
4
0%
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