Shaffer et al developed a prognostic score for evaluating a patient with the myelodysplastic syndrome (MDS) undergoing allogeneic hematopoietic cell transplantation. This can help to identify a patient who may benefit from more aggressive management. The authors are from Memorial Sloan Kettering Cancer Center.
Patient selection: MDS with allogeneic hematopoietic cell transplant, age >= 18 years
Outcome: overall survival
Parameters:
(1) age in years
(2) Karnofsky Performance Score (KPS)
(3) cytogenetics
(4) percent blasts in peripheral blood prior to transplant
(5) platelet count before transplant
|
Parameter |
Finding |
Points |
|
age in years |
18 to 29 years of age |
0 |
|
|
30 to 49 years |
1 |
|
|
>= 50 years |
2 |
|
Karnofsky Performance Score |
90 to 100 |
0 |
|
|
< 90 |
1 |
|
Cytogenetics |
very good |
0 |
|
|
good |
0 |
|
|
intermediate |
0 |
|
|
poor |
1 |
|
|
very poor |
1 |
|
|
monosomal karyotype (MK) |
2 |
|
percent blasts |
<= 3% |
0 |
|
|
> 3% |
1 |
|
platelet count |
> 50,000 per µL |
0 |
|
|
<= 50,000 per µL |
1 |
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the worse the overall survival.
|
Total Score |
Risk Group |
4 Year Survival HLA Matched |
4 Year Survival Mismatched |
|
0 or 1 |
low |
63% |
44% |
|
2 or 3 |
intermediate |
45% |
31% |
|
4 or 5 |
high |
36% |
22% |
|
6 or 7 |
very high |
25% |
22% |
from Figure 1
Specialty: Hematology Oncology, Clinical Laboratory, Surgery, general
