The SOMA (Subjective, Objective, Management, Analytic) – LENT (Late Effects of Normal Tissue) scoring system can be used to evaluate a patient with hematologic complications following radiation and chemotherapy.
Subjective measures:
(1) anemia symptoms
(2) leukopenia symptoms
(3) thrombocytopenia symptoms
Objective measures:
(1) anemia
(2) leukopenia
(3) thrombocytopenia
Management measures:
(1) anemia
(2) leukopenia
(3) thrombocytopenia
Analytic studies:
(1) assays to assess bone marrow reserves (hematopoietic progenitor cell assays; stromal cell assays; growth factor production; primitive stem cell assays)
(2) if bone marrow transplant, studies for chimerism and clonality for donor vs host
(3) challenge with growth factors to assay stem cell reserve
If no toxicity is present, then the 0 points are assigned.
If a toxicity is present, then the grade indicates the number of points to assign.
|
Items |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
anemia symptoms |
NA |
fatigue |
exhaustion |
NA |
|
leukopenia symptoms |
NA |
NA |
fever |
NA |
|
thrombo-cytopenia symptoms |
NA |
NA |
easy bruisability |
spontaneous bleeding |
|
anemia |
NA |
hemoglobin < 10 g/dL; hematocrit < 30% |
pallor |
tachypnea |
|
leukopenia |
NA |
WBC < 2,000 per µL |
infection |
sepsis |
|
thrombo-cytopenia |
abnormal bone marrow aspirate or biopsy |
platelet count 20,001 – 100,000 per µL |
platelet count 5,001 to 20,000 per µL; petechiae |
platelet count <= 5,000 per µL; hemorrhage |
|
anemia management |
NA |
NA |
occasional use of red blood cell products |
frequent use of red blood cell products |
|
leukopenia management |
NA |
NA |
antibiotics and/or cytokines |
NA |
|
thrombo-cytopenia managemenet |
NA |
NA |
platelet or red blood cell transfusion |
bone marrow transplant |
total score =
= SUM(points for all 9 items)
LENT score =
= (total score) / 9
Interpretation:
• maximum total score: 33
• minimum LENT score: 0
• maximum LENT score: 3.67
Specialty: Hematology Oncology
