The Severity-Weighted Assessment Tool (SWAT) can be used to quantify the disease burden in patients with a mycosis fungoides-type cutaneous T cell lymphoma. This can be used to monitor progression of disease or response to therapeutic intervention. The authors are from Case Western Reserve University, University of Michigan, and Salford Royal Hospitals (in Manchester).
Evaluation: percent body surface area (BSA) involved by:
(1) patches
(2) plaques
(3) tumors
(4) ulcerations
Measurement of body surface area involvement can be done by:
(1) morphometric point counting on standardized front and back photographs (described in Assessment under Patients and Methods, page 43).
(2) estimates using the palm of the hand or other measure
SWAT =
= (percent BSA with patches) + (2 * (percent BSA with plaques)) + (3 * (percent BSA with tumors)) + (3 * (percent BSA with ulcerations))
Interpretation:
• minimum score: 0
• maximum score: 300
• The higher the score, the greater the tumor burden.
Performance:
• SWAT was felt to be more accurate than the total percent BSA involved alone, especially for mixed responses to therapy.
• The SWAT score increased as the physician global assessment indicated more severe disease.
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