Ramos et al reported a score for evaluating a patient with acute myeloid leukemia (AML) who is treated with azacitidine. This is a hypomethylating agent that is usually given to patients who are unfit for more intensive chemotherapy. The authors are from multiple institutions in Europe.
ALMA = Azacitidina en el tratamiento de la Leucemia Mieloblastica Aguda
Patient selection: unfit AML patient (due to age, comorbidity, etc), who is to be treated with azacitidine (AZA)
Parameters:
(1) ECOG performance status
(2) white blood cell count prior to starting AZA
(3) cytogenetics
Parameter
Finding
Points
ECOG performance
0
0
1 or 2
1
3 or 4
2
WBC count
<= 10 * 10^9/L
0
> 10 * 10^9/L
1
cytogenetics
normal
0
abnormal
1
where:
• The score refers to normal cytogenetics, but some abnormal karyotypes are considered favorable. Under Materials and Methods it is stated that AZA is not usually given to a patient with low-risk cytogenetics.
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the worse the outcome.
Score
Group
0
favorable
1 or 2
intermediate
3 or 4
unfavorable
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