Lugli et al developed a morphological score for evaluating the response of a patient with chronic myelogenous leukemia (CML) to therapy with imatinib mesylate. The authors are from multiple hospitals in Switzerland.
Parameters:
(1) histologic features in a bone marrow core biopsy
(2) cytologic features in bone marrow aspirate
Histologic features:
(1) cellularity
(2) myeloid to erythroid (M:E) ratio
(3) fibrosis
(4) abnormal megakaryocytes
|
Parameter |
Finding |
Points |
|
cellularity |
not increased for age |
0 |
|
|
increased for age |
1 |
|
M:E ratio |
<= 4:1 |
0 |
|
|
> 4:1 |
1 |
|
fibrosis |
grade 0 to 2 |
0 |
|
|
grade 3 or 4 |
1 |
|
abnormal megakaryocytes |
< 10% of all megakaryocytes |
0 |
|
|
>= 10% of all megakaryocytes |
1 |
where:
• Fibrosis may not reverse, or else only reverse slowly.
Cytologic features:
(1) nature of tap
(2) percentage of blasts
(3) percentage of basophils
|
Parameter |
Finding |
Points |
|
type of tap |
not dry |
0 |
|
|
dry |
1 |
|
percent blasts |
dry tap |
0 |
|
|
not dry and < 5% |
0 |
|
|
not dry and >= 5% |
1 |
|
percent basophils |
dry tap |
0 |
|
|
not dry and < 1% |
0 |
|
|
not dry and >= 1% |
1 |
total score =
= SUM(points for histologic features) + (points for cytologic features)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the less the morphologic response to therapy.
Specialty: Hematology Oncology
