Wierda et al develop a prognostic index for evaluating an untreated patient with chronic lymphocytic leukemia (CLL). This can help to identify a patient who may benefit from more aggressive or a novel therapy. The authors are from the M.D. Anderson Cancer Center in Houston.
Parameters:
(1) age in years
(2) serum beta-2 microglobulin in mg/L
(3) absolute lymphocyte count
(4) gender
(5) Rai stage
(6) number of involved nodal groups
|
Parameter |
Finding |
Points |
|
age in years |
< 50 years |
1 |
|
|
50 to 65 years |
2 |
|
|
> 65 years |
3 |
|
serum beta-2 microglobulin |
< ULN |
0 |
|
|
>= ULN and <= 2 * ULN |
1 |
|
|
> 2 * ULN |
2 |
|
absolute lymphocyte count |
< 20,000 per µL |
0 |
|
|
20,000 to 50,000 per µL |
1 |
|
|
> 50,000 per µL |
2 |
|
gender |
female |
0 |
|
|
male |
1 |
|
Rai stage |
0, I or II |
0 |
|
|
III or IV |
1 |
|
number of involved nodal groups |
0 to 2 |
0 |
|
|
3 or more |
1 |
where:
• ULN = upper limit of normal
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 1
• maximum score: 10
• The higher the score the worse the prognosis.
|
Total Score |
Risk Group |
10 Year Overall Survival |
|
1 to 3 |
low |
80% |
|
4 to 7 |
intermediate |
52% |
|
8 to 10 |
high |
26% |
Specialty: Hematology Oncology
