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Model of Zhang et al for Predicting Early Death for a Patient with Acute Promyelocytic Leukemia (APML)

Description

Zhang et al reported a model for predicting the risk of early death for a patient with acute promyelocytic leukemia (APML). This can help to identify a patient who may benefit from more agressive management. The authors are Harbin Medical University, The First Affiliated Hospital and The Fourth Affiliated Hospital in Harbin, China.


Patient selection: acute promyelocytic leukemia (APML)

 

Parameters:

(1) relapse (vs de novo)

(2) age in years

(3) white blood cell count in 10^9/L

(4) plasma fibrinogen in g/L

(5) serum creatinine in µmol/L

(6) uric acid in µmol/L

(7) serum albumin in g/L

(8) serum AST in U/L

 

Parameter

Finding

Points

relapse

no

0

 

yes

1.149

age in years

<= 48 years

0

 

> 48 years

0.638

WBC

<= 7 * 10^9

0

 

> 7 * 10^9/L

0.676

fibrinogen

>= 1 g/L

0

 

< 1 g/L

1.476

serum creatinine

<= 75 µmol/L

0

 

> 75 µmol/L

1.759

uric acid

<= 290 µmol/L

0

 

> 290 µmol/L

0.562

serum albumin

< 40 g/L

1.099

 

>= 40 g/L

0

serum AST

< 26 U/L

0

 

>= 26 U/L

0.798

 

total score =

= SUM(points for all 8 parameters) - 4.487

 

probability of early death =

= 1 / (1 _EXP((-1) * (score)))

 

The authors recognized 3 risk grades using the sum of the 8 parameters, without the coefficient.

 

Score without Coefficient

Risk Group

Corresponding Percent

< 1.54

low

< 5%

1.54 to 3.64

intermediate

5 to 30%

> 3.64

high

> 30%

 


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