Parameters:
(1) pseudo-Pelger-Huet anomaly in mature neutrophils in the bone marrow
(2) karyotype on bone marrow cytogenetics
(3) hemoglobin
(4) micromegakaryocytes in the bone marrow
The patient is high risk if the pseudo-Pelger-Huet anomaly is seen in >= 3% of neutrophils.
A patient is intermediate risk of any of the following are present:
(1) karyotype is other than good
(2) hemoglobin <= 6 g/dL
(3) micromegakaryocytes in the bone marrow are >= 10%
A patient is low risk if not either high or intermediate risk.
where:
• Good karyotype is as defined for the International Prognostic Scoring System (above) - normal, isolated del(5q), isolated del(20q), Y(-).
• For evaluation of megakaryocyte morphology, >= 25 megakaryocytes are examined.
• A micromegakaryocyte is either mononucleated or binucleated and <= 1.5 times the diameter of a promyelocyte.
• For evaluation of the Pelger-Huet anomaly, >= 200 neutrophils in the bone marrow are examined.
• The Pelger-Huet anomaly involves hypo-segmented mature neutrophils.
|
Risk Group
|
Median Survival in Months
|
|
high risk
|
18 months
|
|
intermediate risk
|
100 months
|
|
low risk
|
> 225 months
|
from Figure 6, page 1732.
