Wolanksyj et al identified risk factors for mortality in a patient with essential thrombocythemia. These can help identify a patient who may benefit from closer monitoring and more aggressive management. The authors are from the Mayo Clinic in Rochester, Minnesota.
Parameters from multivariate analysis:
(1) age
(2) white blood cell count at diagnosis
(3) tobacco use
(4) diabetes mellitus
|
Parameter |
Findings |
Points |
Risk Ratio |
|
age in years |
< 60 years |
0 |
1 |
|
|
>= 60 years |
3 |
4.9 |
|
WBC count at diagnosis |
< 15,000 per µL |
0 |
1 |
|
|
>= 15,000 per µL |
1 |
1.7 |
|
tobacco use |
absent |
0 |
1 |
|
|
present |
1 |
1.9 |
|
diabetes mellitus |
absent |
0 |
1 |
|
|
present |
2 |
3.6 |
where:
• The point assignment is based on the risk ratio divided by 1.7 (risk for WBC count)
mortality risk score =
= SUM(points for the 4 risk factors)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the higher the mortality and the lower the survival.
If just the patient's age and initial white blood cell count are considered:
|
Age in Years |
WBC Count at Diagnosis |
Risk Group |
|
< 60 years |
< 15,000 per µL |
low |
|
< 60 years |
>= 15,000 per µL |
intermediate |
|
>= 60 years |
< 15,000 per µL |
intermediate |
|
>= 60 years |
>= 15,000 per µL |
high |
from Figure 3, page 164)
|
Risk Group |
10 Year Survival |
20 Year Survival |
|
low |
95% |
72% |
|
intermediate |
83% |
29% |
|
high |
53% |
0% |
Specialty: Hematology Oncology
ICD-10: ,
