Pastore et al developed two scores for evaluating patients with cytogenetically normal acute myeloid leukemia (AML). These can help to identify a patient who may benefit from more aggressive or a more novel therapy. The authors are from multiple hospitals in Germany, the United States and New Zealand.
Patient selection: cytogenetically normal AML
Parameters:
(1) NPM1+ (mutation in the nucleophosmin gene)
(2) FLT3-ITD+ (internal tandem duplication of FLT3 gene)
(3) combination of NPM1+ and FLT3-ITD+
(4) biCEBPA (biallelic CEBPA mutation)
(5) white blood cell count (WBC) count in 10^6/L
(6) age in years
(7) ECOG status
|
Parameter |
Findings |
Points |
|
NPM1+ |
absent |
0 |
|
|
present |
1 |
|
FLT3-ITD+ |
absent |
0 |
|
|
present |
1 |
|
combination NPM1+ and FLT3-ITD+ |
absent (none or one) |
0 |
|
|
both presesnt |
1 |
|
biCEBPA |
absent |
0 |
|
|
present |
1 |
|
ECOG status |
0 or 1 |
0 |
|
|
2, 3 or 4 |
1 |
where:
• The white blood cell count is reported in 10^6/L. A WBC count of 10,000 per microliter (10 * 10^9/L) would be 10,000 * 10^6/L with LOG10 = 4.
PINA(OS) =
= (0.4 * (points for ECOG)) + (0.044 * (age in years)) + (0.57 * LOG10(WBC count)) - (1.3 * (points for biCEBPA)) - (0.26 * (points for FLT3)) - (1.2 * (points for NPM1+)) + (0.89 * (points for NPM1+ and FLT3))
|
PINA(OS) |
Risk Group |
5-Year Overall Survival |
|
< 4.0 |
low |
74% |
|
4.0 to 5.39 |
intermediate |
26% |
|
>= 5.4 |
high |
2% |
from Figure 2
Specialty: Hematology Oncology
ICD-10: ,
