Shah et al developed the immunodeficiency scoring index (ISI) to evaluate hematopoietic stem cell transplant recipients with a respiratory syncytial viral (RSV) infection. The authors are from the University of Texas MD Anderson Cancer Center, Baylor College of Medicine, and the University of Texas School of Public Health in Houston.
Patient selection: hematopoietic stem cell transplant (HSCT) with RSV infection
Parameters:
(1) absolute neutrophil count per microliter
(2) absolute lymphocyte count per microliter
(3) age in years
(4) myeloablative conditioning regimen
(5) acute or chonic graft-vs-host disease (GVHD)
(6) corticosteroid therapy within the past 30 days
(7) recent (within past 30 days) or pre-engraftment allo-HSCT
|
Parameter |
Finding |
Points |
|
absolute neutrophil count |
>= 500 per µL |
0 |
|
|
< 500 per µL |
3 |
|
absolute lymphocyte count |
>= 200 per µL |
0 |
|
|
< 200 per µL |
3 |
|
age in years |
< 40 years of age |
0 |
|
|
>= 40 years of age |
2 |
|
myeloablative conditioning |
no |
0 |
|
|
yes |
1 |
|
GVHD |
no |
0 |
|
|
yes |
1 |
|
corticosteroid therapy |
no |
0 |
|
|
yes |
1 |
|
recent or pre-engraftment allo-HSCT |
no |
0 |
|
|
yes |
1 |
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk for progression from upper respiratory tract to lower respiratory tract infection and the greater the risk for mortality.
• The risk for a worse outcome is greater if the patient is not started on ribavirin while in the upper respiratory tract infection stage.
|
Score |
Risk |
|
0 to 2 |
low risk |
|
3 to 6 |
moderate risk |
|
7 to 12 |
high risk |
Specialty: Infectious Diseases, Pedatrics
