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Prognostic Score of Offidani et al for Patients with a Hematologic Malignancy, Febrile Neutropenia and a Pulmonary Infiltrate

Description

Offidani et al identified risk factors for patients with hematologic malignancies who developed febrile neutropenia and pulmonary infiltrates. This can help identify patients who require more aggressive monitoring and intervention. The authors are from the University of Ancona/Azienda Ospedaliera Umberto I in Italy


 

Patient selection:

(1) AML

(2) ALL

(3) non-Hodgkin's lymphoma

(4) multiple myeloma

(5) blast crisis in CML

 

Parameters:

(1) change in white blood cell count

(2) C-reactive protein level

(3) serum albumin

Parameter

Finding

Points

change in white blood cell count

favorable (recovering following aplasia; absolute neutrophil count > 500 per µL at onset of fever and pulmonary infiltrates)

1

 

unfavorable (decreasing, or not recovering after aplasia)

0

C-reactive protein

< 10 mg/dL

1

 

>= 10 mg/dL

0

serum albumin

< 3 g/dL

0

 

>= 3 g/dL

1

 

favorable risk factor score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The higher the score the more favorable the outcome.

 

Favorable Risk Score

Risk Group

Survival Rate

2 or 3

low risk

95%

0 or 1

high risk

46%

 

Performance:

• The specificity was 88% and sensitivity 75%.

• The positive predictive value was 95% and the negative predictive value was 54%.

 


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