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Score of Hellstrom-Lindberg for Predicting Response to Erythropoietin Plus Granulocyte Colony Stimulating Factor in an Anemic Patient with Myelodysplasia

Purpose: To determine if an anemic patient with myelo-dysplasia will respond to therapy with erythropoietin plus GCSF based on the score of Hellstrom-Lindberg.

Description

Hellstrom-Lindberg developed a simple score that can identify if a patient with anemia and myelodysplasia is likely to respond to erythropoietin plus granulocyte colony stimulating factor (GCSF) therapy.


Myelodysplasia included refractory anemia, refractory anemia with ringed sideroblasts, and refractory anemia with excess blasts (RAEB).

 

Parameters:

(1) serum erythropoietin concentration

(2) monthly blood transfusions

 

Parameter

Finding

Points

serum erythropoietin

< 100 IU/L

2

 

100 - 500 IU/L

1

 

> 500 IU/L

-3

monthly blood transfusion

< 2 units per month

2

 

>= 2 units per month

-2

 

where:

• In the implementation the average monthly blood transfusion for the past 6 months will be used to derive the monthly blood transfusion value.

• The type of myelodysplasia was not used as a risk factor. Other scores consider RAEB as an indicator for a poor response.

 

score =

= (points for serum erythropoietin concentration) + (points for monthly blood transfusions)

 

Interpretation:

• minimum score: -5

• maximum score: 4

• The higher the score the more likely the patient will have a response to therapy.

 

Total Score

Predicted Response

2 to 4

good

-1 to 1

fair (intermediate)

-5 to -2

poor

 

A complete response was considered maintaining a stable hemoglobin > 11.5 g/dL.


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Specialty

Objective

ICD-10