Juan et al developed a model for predicting the risk of severe anemia in a patient with a non-hematologic malignancy treated with conventional chemotherapy. This can help identify patients who may benefit from closer monitoring and from erythropoietin therapy. The authors are from Hospital Arnau du Vilanova in Valencia, Spain.
Criteria for severe anemia - one or both of the following:
(1) hemoglobin < 8 g/dL
(2) poorly tolerated anemia < 10 g/dL requiring red blood cell transfusion
Parameters identified on multivariate analysis:
(1) presence of metastases
(2) radiation therapy
(3) number of previous red blood cell transfusions
(4) height in centimeters
(5) baseline hemoglobin in g/dL
(6) platelet count
(7) decrease in hemoglobin after first course of chemotherapy
|
Parameter |
Finding |
Points |
|
metastases |
absent |
0 |
|
|
present |
1 |
|
concomitant radiation therapy |
none |
0 |
|
|
given |
2 |
|
number of RBC transfusions |
none |
0 |
|
|
1 |
1 |
|
|
> 1 |
2 |
|
height in cm |
< 160 cm |
0 |
|
|
160 - 180 cm |
2 |
|
|
> 180 cm |
4 |
|
baseline hemoglobin |
> 13 g/dL |
0 |
|
|
11 - 13 g/dL |
2 |
|
|
< 11 g/dL |
4 |
|
platelet count |
normal or decreased |
0 |
|
|
increased |
1 |
|
decrease in hemoglobin after first course of chemotherapy |
< 0.6 g/dL |
0 |
|
|
0.6 to 1.8 g/dL |
1 |
|
|
> 1.8 g/dL |
2 |
where:
• The platelet count could be handled as whether count after chemotherapy is greater than baseline platelet count.
• The model does not seem to distinguish regional from distant metastases.
• I am not sure why height appears as an independent risk factor.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: 0
• maximum score: 16
• The higher the score the greater the risk of severe anemia.
|
Total Score |
Probability of Severe Anemia |
|
0 to 3 |
< 1% |
|
4 to 6 |
< 25% |
|
7 or 8 |
25 - 50% |
|
9 or 10 |
50 - 85% |
|
11 to 16 |
>= 85% |
Specialty: Hematology Oncology, Pharmacology, clinical
ICD-10: ,
