Shenkier et al identified prognostic factors affecting overall survival in immunocompetent patients with a primary central nervous system (CNS) lymphoma. This can help identify patients who may require more aggressive management. The authors are from the British Columbia Cancer Agency.
Parameters:
(1) age
(2) serum LDH
(3) total dose of methotrexate in grams per square meter body surface area
Parameter
Finding
Points
age of the patient
<= 60 years of age
0
> 60 years of age
1
serum LDH
<= upper limit of the normal reference range (ULN)
0
> ULN
1
treatment with methotrexate
none
1
any
0
where:
• The authors did not notice a difference in overall survival for patients receive 1 or 8 g methotrexate per square meter BSA.
• The hazard ratio for each risk factor is 2.2-2.3 (Table 6, page 1014).
total number of adverse risk factors =
= SUM(points for all 3 parameters)
Interpretation:
• minimum number of risk factors: 0
• maximum number of risk factors: 3
• A patient with 0 risk factors had the best overall survival.
• The more the factors that the patient had the worse the overall survival.
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