Morel et al developed a prognostic scoring system for patients with Waldenstrom's Macroglobulinemia based on age and laboratory test results. 232 patients were used in the score development, with 167 in the validation set. The study was done in Lens, France.
Parameters:
(1) age of the patient
(2) serum albumin
(3) number of cytopenias
Definition of cytopenia:
(1) hemoglobin < 12 g/dL
(2) platelet count < 150 * 10^9/L (150,000 per µL)
(3) leukocytes < 4 * 10^9/L (4,000 per µL)
|
Parameter |
Finding |
Points |
|
age |
< 65 years |
0 |
|
|
>= 65 years |
1 |
|
albumin |
>= 40 g/L |
0 |
|
|
< 40 g/L |
1 |
|
cytopenias |
0 |
0 |
|
|
1 |
1 |
|
|
2 or 3 |
2 |
total score =
= SUM(points for findings present)
Interpretation:
• minimum score: 0
• maximum score: 4
|
Total Score |
Risk |
5 Year Survival |
|
0 or 1 |
low |
86%, 92% |
|
2 |
intermediate |
61%, 63% |
|
3 or 4 |
high |
26%, 27% |
where:
• The first survival figure was from the abstract, the second from the article.
In patients < 65 years of age, the only independent prognostic factor was the presence of 2 or 3 cytopenias.
In patients >= 65 years of age:
(1) reduced albumin and
(2) the presence of 1 or more cytopenias
were independent prognostic factors. The 5 year survival with neither factor was 92%, for 1 factor 62% and for both 27%.
Specialty: Hematology Oncology
