Cytogenetics can identify patients with favorable and unfavorable prognosis, but is less effective for patients with intermediate-risk karyotypes. Rollig et al developed a score for separating these patients into two prognostic groups. The authors are from multiple hospitals in Germany and are members of the Study Alliance Leukemia.
Patient selection: older adult (> 60 years of age) with AML showing intermediate risk cytogenetics
Parameters:
(1) age in years
(2) serum LDH concentration
(3) WBC count
(4) CD34 expression in peripheral blood or bone marrow as percent of all mononuclear cells
(5) NPM1 status
Parameter
Finding
Points
age in years
<= 65 years
0
> 65 years
3
serum LDH
<= 700 U/L
0
> 700 U/L
4
WBC count
<= 20,000 per µL
0
> 20,000 per µL
2
CD34 expression
<= 10%
0
> 10%
2
NPM1 status
wild type
0
mutated
-2
where:
• The cutoff for WBC count is given as "20 per µL".
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: -2
• maximum score: 11
• A score > 3 was designated adverse intermediate with a 3-year overall survival 10.6%
• A score <= 3 was designated good intermediate with a 3-year overall survival 30%.
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