Pastore et al developed two scores for evaluating patients with cytogenetically normal acute myeloid leukemia (AML). These can help to identify a patient who may benefit from more aggressive or a more novel therapy. The authors are from multiple hospitals in Germany, the United States and New Zealand.
Patient selection: cytogenetically normal AML
Parameters:
(1) NPM1+ (mutation in the nucleophosmin gene)
(2) FLT3-ITD+ (internal tandem duplication of FLT3 gene)
(3) combination of NPM1+ and FLT3-ITD+
(4) biCEBPA (biallelic CEBPA mutation)
(5) white blood cell count (WBC) count in 10^6/L
(6) age in years
Parameter
Findings
Points
NPM1+
absent
0
present
1
FLT3-ITD+
absent
0
present
1
combination NPM1+ and FLT3-ITD+
absent (none or one)
0
both presesnt
1
biCEBPA
absent
0
present
1
where:
• The white blood cell count is reported in 10^6/L. A WBC count of 10,000 per microliter (10 * 10^9/L) would be 10,000 * 10^6/L with LOG10 = 4.
PINA(RFS) =
= (0.018 * (age in years)) + (0.54 * LOG10(WBC count)) - (1.34 * (points for biCEBPA)) - (0.44 * (points for FLT3)) - (1.61 * (points for NPM1+)) + (1.24 * (points for NPM1+ and FLT3))
PINA(OS)
Risk Group
5-Year RF Survival
< 2.0
low
55%
2.0 to 2.89
intermediate
28%
>= 2.9
high
5%
from Figure 2
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