Baldini et al developed a prognostic score for predicting the risk of asymptomatic macroglobulinemia progressing to a symptomatic lymphoid disorder. This can help identify patients who may require more aggressive management and closer monitoring. The authors are from multiple hospitals in Italy (Gruppo Italiano Studio Linformi Centres) and France.
Asymptomatic macroglobulinemia includes patients with:
(1) immunoglobulin M monoclonal gammopathy of undetermined significance (IgM MGUS)
(2) indolent Waldenstrom's macroglobulinemia (IWM)
Parameters:
(1) serum monoclonal component
(2) hemoglobin
(3) gender
|
Parameter |
Finding |
Points |
|
serum monoclonal protein |
< 0.7 g/dL |
0 |
|
|
0.7 - 1.399 g/dL |
1 |
|
|
1.4 - 2.099 g/dL |
2 |
|
|
>= 2.1 g/dL |
3 |
|
hemoglobin |
>= 15 g/dL |
0 |
|
|
13 - 14.99 g/dL |
1 |
|
|
11 - 12.99 g/dL |
2 |
|
|
< 11 g/dL |
3 |
|
gender |
female |
0 |
|
|
male |
3 |
where:
• Other scores use different hemoglobin cutoffs for men and women.
total risk score =
= SUM(points for the 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
• The higher the score the greater the risk of progression to a symptomatic lymphoid disorder.
|
Risk Score |
Risk |
Progression at 10 Years in IgM MGUS |
Progression at 14 Years IgM MGUS |
|
0 to 2 |
low |
5% |
5% |
|
3 to 5 |
intermediate |
10% |
30% |
|
6 to 9 |
high |
50% |
50% |
|
Risk Score |
Risk |
Progression at 10 Years in IWM |
Progression at 14 Years IWM |
|
0 to 2 |
low |
10% |
10% |
|
3 to 5 |
intermediate |
30% |
40% |
|
6 to 9 |
high |
50% |
80% |
Specialty: Hematology Oncology
