Jourdan et al developed a prognostic score for young adults with acute myeloblastic leukemia (AML) in a first complete remission but without an HLA-identical donor for a stem cell transplant. This can help identify patients who may benefit from more aggressive management. The authors are the Boureaux Grenoble Marseille Toulouse intergroup representing multiple hospitals in France.
A patient without a suitable HLA-identical donor received more intensive chemotherapy and/or an autologous stem cell transplant.
Parameters:
(1) cytogenetics
(2) number of course of therapy required to achieve a complete first remission
(3) French-American-British (FAB) classification of the AML
(4) initial white blood cell (WBC) count
|
Cytogenetics |
Points |
|
favorable |
0 |
|
intermediate |
1 |
|
nonassessable |
2 |
|
unfavorable |
3 |
Favorable: t(15;17), t(q22;q12), t(8; 21)(q22;q22); inv(16)(p13;q22)
Intermediate: normal karyotype, or not favorable/unfavorable
Unfavorable: complex, del(5q)/-5, -7, -7, 3q rearrangement, t(9; 22), t(6;9), 11q23 rearrangements except t(9;11)
|
Parameter |
Finding |
Points |
|
number of courses of therapy |
1 course |
0 |
|
|
2 courses |
1 |
|
FAB classification |
M1, M2, M3, M4 or M5 |
0 |
|
|
M0, M6, M7 |
1 |
|
initial WBC count |
<= 30,000 per µL |
0 |
|
|
> 30,000 per µL |
1 |
number of risk factors =
= SUM(points for the 3 parameters)
|
Cytogenetics Points |
Number of Risk Factors |
Risk Group |
|
0 |
0, 1, or 2 |
low |
|
0 |
3 |
intermediate |
|
1 |
0 or 1 |
intermediate |
|
1 |
2 or 3 |
high |
|
2 |
0 |
intermediate |
|
2 |
1, 2 or 3 |
high |
|
3 |
0, 1, 2, or 3 |
high |
|
Prognostic Group |
Probability of 10 Year Survival |
|
low risk |
74% |
|
intermediate risk |
47% |
|
high risk |
17% |
Specialty: Hematology Oncology, Surgery, general
ICD-10: ,
