An international working group was formed to standardize response criteria for therapy of myelodysplastic syndromes (MDS). One measure is the level of improvement in hematologic parameters. The authors are from multiple institutions in Europe and the United States.
Measures of hematologic improvement (HI):
(1) erythroid response (HI-E)
(2) platelet response (HI-P)
(3) neutrophil response (HI-N)
|
Pretreatment Status |
Change |
Improvement |
|
hemoglobin < 11 g/dL |
increase hemoglobin > 2 g/dL |
erythroid, major |
|
hemoglobin < 11 g/dL |
increase hemoglobin 1-2 g/dL |
erythroid, minor |
|
RBC transfusion dependent |
transfusion independent |
erythroid, major |
|
RBC transfusion dependent |
transfusion requirement decreased >= 50% |
erythroid, minor |
|
platelet count < 100,000 per µL |
absolute increase >= 30,000 per µL |
platelet, major |
|
platelet count < 100,000 per µL |
absolute increase from 10,000 to 30,000 per µL with >= 50% increase in platelet count |
platelet, minor |
|
platelet transfusion dependent |
transfusion independent with stabilized counts |
platelet, major |
|
absolute neutrophil count < 1,500 per µL |
>= 100% increase AND an absolute increase >= 500 per µL |
neutrophil, major |
|
absolute neutrophil count < 1,500 per µL |
>= 100% increase AND an absolute increase < 500 per µL |
neutrophil, minor |
where:
• The wording for a major improvement in the neutrophil count was "at least a 100% increase, or an absolute increase of more than 500 per cubic mm, whichever is greater." Depending on how you read this, this could overlap with the criteria for a minor response.
• A percent increase in count would be ((after) - (before)) / (before) * 100%.
Improvements must:
(1) last >= 2 months
(2) persist in the absence of cytotoxic therapy (in some circumstances this may allow for patients on a protocol requiring maintenance or consolidation therapy)
Specialty: Hematology Oncology, Clinical Laboratory
ICD-10: ,
