Lee et al assigned patients with chronic lymphocytic leukemia (CLL) to risk groups based on clinical and laboratory findings. This can help identify patients who may benefit from more aggressive management. The authors are M.D. Anderson Hospital in Houston.
Parameters:
(1) serum uric acid
(2) serum alkaline phosphatase
(3) serum LDH
(4) age in years
(5) external lymphadenopathy
(6) Rai stage
|
Parameter |
Finding |
Points |
|
serum uric acid |
<= 7.0 mg/dL |
0 |
|
|
> 7.0 mg/dL |
1 |
|
serum alkaline phosphatase |
<= 80 mU/mL (U/L) |
0 |
|
|
> 80 U/L |
1 |
|
serum LDH |
<= 325 U/L |
0 |
|
|
> 325 U/L |
1 |
|
age in years |
<= 60 years |
0 |
|
|
> 60 years of age |
1 |
|
external lymphadenopathy |
absent |
0 |
|
|
present |
1 |
where:
• The normal reference range for serum uric acid: not given
• The normal reference range for serum alkaline phosphatase: not given
• The normal reference range for serum LDH: not given
risk score =
= (points for serum uric acid) + (points for serum alkaline phosphatase) + (points for age) + (points for external lymphadenopathy)
Interpretation:
• minimum risk score: 0
• maximum risk score: 4
|
Serum LDH Points |
Risk Score |
Risk Group |
|
0 |
0 or 1 |
low |
|
0 |
2 or 3 |
intermediate |
|
0 |
4 |
high |
|
1 |
0 or 1 |
intermediate |
|
1 |
2 or 3 |
high |
|
1 |
4 |
high |
|
Risk Group |
Rai Stage |
Median Survival in Months (1987) |
|
low |
0 |
>= 164 months |
|
low |
1 |
100 months |
|
low |
2 |
122 months |
|
low |
3 or 4 |
57 months |
|
intermediate |
0 |
40 months |
|
intermediate |
1 |
70 months |
|
intermediate |
2 |
51 months |
|
intermediate |
3 or 4 |
29 months |
|
high |
0 |
NA |
|
high |
1 |
27 months |
|
high |
2 |
29 months |
|
high |
3 or 4 |
24 months |
where:
• Lymphadenopathy indicates Rai Stage I.
Limitations:
• The methods used for the serum tests and the reference ranges were not given. The analytical method is referred to as a 12 channel automated biochemical analyzer.
Specialty: Hematology Oncology
