The ITACA (Italy and Canada) score of Buckstein et al can be used to evaluate the response of a patient with myelodysplasia to an erythropoietin stimulating agent. The authors are from Sunnybrook Health Sciences in Toronto and Elena National Cancer Institute in Rome.
Patient selection: myelodysplasia
Outcome: response to the erythropoietic stimulating agent
Parameters:
(1) transfusion independence (less than 1 unit per 8 weeks for 16 weeks; this would be less than 2 units over 4 months)
(2) serum EPO concentration in U/L prior to starting therapy
(3) MDS IPSS
Parameter
Finding
Points
transfusion independence
no
0
yes
1
serum EPO
< 100 U/L
1
>= 100 U/L
0
IPSS
low risk
1
intermediate or high
0
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• The higher the score the better the response to the agent.
Score
Response Rate
0
22%
1
43%
2
67%
3
78-85%
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