Prognostic factors identified on multivariate analysis::
(1) age
(2) cutaneous involvement
(3) WBC count at diagnosis
|
Prognostic Factor
|
Finding
|
Points
|
|
age
|
<= 30 years of age
|
0
|
|
|
> 30 years of age
|
1
|
|
cutaneous involvement
|
absent
|
1
|
|
|
present
|
0
|
|
WBC count
|
not elevated
|
0
|
|
|
elevated
|
1
|
where:
• The scoring are oversimplifications since the hazard ratios are not equal.
• The hazard ratio increases 1.089 for each increment of 1,000 per µL. The problem is that this not straightforward to use. The median values were in the range 5,000 - 6000 per µL (Table 6, page 1027). For the implementation I will use > 10,000 per µL as elevated.
total number of poor prognostic factors =
= SUM(points for the poor prognostic factors)
Interpretation:
• minimum number: 0
• maximum number: 3
• The higher the number the worse the prognosis.
Additional adverse prognostic factors not significant in multivariate analysis:
(1) lymphoma form (in Figure 1, page 1026, both the leukemia and lymphoma show a similar median survival. All of the patients with lymphoma were dead at 3 years, while 20% of patients with leukemia lived > 5 years).
(2) absence of mediastinal involvement (on univariate analysis)
(3) negative TdT (on univariate analysis)
(4) elevated LDH (on univariate analysis)
