Better prognostic group - all of the following:
(1) age < 60
(2) better cytogenetic findings: inv 16; t(16;16); t(8;21)
(3) ECOG/Zubrod performance score of 0, 1 or 2 (not bedridden more than half of the day).
(4) no history of antecedent hematologic disorders (myelodysplasia, etc.)
(5) MDR1 (multi-drug resistant protein) negative
where:
• Items 3 to 5 are not listed in the paper but seem appropriate based on the intermediate and worse prognosis groups below.
Intermediate prognostic group: all of the following
(1) age < 70
(2) no history of antecedent hematologic disorders (myelodysplasia, etc.)
(3) ECOG/Zubrod performance score of 0, 1 or 2 (not bedridden more than half of the day)
(4) MDR1 (multi-drug resistant protein) negative
(5) intermediate cytogenetic findings: monosomy 5 (-5), monosomy 7 (-7), deletion of the long arm of 5 (5q-), deletion of the long arm of 7 (7q-), complex abnormalities (abnormalities affecting >= 3 chromosomes)
Worse prognostic group: anyone not in the better or intermediate prognostic groups.
The worse prognostic group includes a group of patients likely to die during induction therapy. This includes either:
(1) patients > 80 years of age, OR
(2) ECOG/Zubrod performance score of 3 or 4 (bedridden most the day or all of the time)
|
Prognostic Group
|
Probability of Survival at 1 Year
|
Probability of Survival at 2 Years
|
|
better
|
85%
|
64%
|
|
intermediate
|
50%
|
32%
|
|
worse
|
24%
|
8%
|
from Figure 2, page 1063.
|
Prognostic Group
|
Preferred Therapy
|
|
better
|
standard therapy indicated
|
|
intermediate
|
either standard or investigational therapy indicated
|
|
worse
|
investigational therapy (standard therapy has little to offer)
|
