Description

Pfeilstocker et al evaluated the role of cytogenetics in determining the prognosis for patients with myelodysplasia. They developed the Prognostic Index for Cytogenetics (pi score) for risk stratification based on bone marrow cytogenetic findings. The authors are from Boltzmann Institute for Leukemia Research and Haematology at the Hanusch Hospital in Vienna, Austria.


Finding on Bone Marrow Cytogenetics

Points

non-complex aberration in a chromosome other than 5, 7 or 8

1

complex aberration in a chromosome other than 5, 7, or 8

4

any aberration in chromosome 5

1

any aberration in chromosome 7

3

any aberration in chromosome 8

3

no aberrations

0

 

where:

• It is unclear if more than 1 non-complex aberration for chromosomes other than 5, 7 or 8 would be counted more than once.

• Complex aberration was not defined. Reference was made to Mitelman F (editor). ISCN 1995, An international system for human cytogenetic nomenclature. Karger, 1995. However, I could not find a definition here. In the IPSS they use >= 3 chromosomal abnormalities as having poor prognostic significance.

• Since the transition to high risk occurs at a score >= 4, any complex cytogenetic questions probably get lumped together.

 

total score =

= SUM(points for all cytogenetics findings)

 

Interpretation:

• minimum score: 0 (diploid karyotype)

• maximum score: 12

• The higher the score the higher the risk.

 

Total Score

Risk

0

very low risk

1

low risk

2 or 3

intermediate risk

>= 4

high risk

 


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