Patnaik et al reported a prognostic score for patients with chronic myelomonocytic leukemia (CMML). The score can help to identify a patient who may benefit from more aggressive or a novel therapy. The authors are from the Mayo Clinic and Universite Paris Descartes.
Patient selection: CMML
Parameters:
(1) ASXL1 mutations (nonsense, frameshift)
(2) absolute monocyte count in 10^9/L
(3) hemoglobin in g/L
(4) platelet count in 10^9/L
(5) circulating immature myeloid cells
Parameter
Finding
Points
ASXL1 mutations
no
0
yes
1
absolute monocyte count
<= 10 * 10^9/L
0
> 10 * 10^9/L
1
hemoglobin in g/L
>= 10 g/dL
0
< 10 g/dL
1
platelet count in 10^9/L
>= 100 * 10^9/L
0
< 100 * 10^9/L
1
circulating immature myeloid cells
no
0
yes
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 5
• The higher the score the worse the prognosis.
Score
Risk Group
Median Survival
0
low
97 months
1
intermediate-1
59 months
2
intermediate-2
31 months
>= 3
high
16 months
The authors note that the ASXL1 mutation is not associated with leukemic transformation.
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