Wierda et al developed nomograms for evaluating an untreated patient with chronic lymphocytic leukemia. This can help to identify a patient who may benefit from more aggressive management or a novel therapy. The authors are from M.D. Anderson Cancer Center in Houston.
Parameters:
(1) age in years
(2) natural logarithm of serum beta-2 microglobulin in mg/L (reference range 0.6 to 2.0 mg/L)
(3) type of therapeutic regimen
points for age =
= (1.333 * (age in years)) - 20
points for beta-2 microglobulin =
= (33.214 * LN (beta-2 microglobulin))
Therapy
Points
fludarabine, cyclophosphamide, rituximab (FCR)
0
fludarabine and cyclophosphamide (FC)
28.8
fludarabine and mitoxantrone (FM)
28.8
fludarabine (F)
33.8
The summation of the points gives an equation that is similar to that given in the paper:
total points =
= (1.33 * (age)) + 33.16 * LN(beta-2 microglobulin)) + 13.74 - (5.01 if treated with FC or FM) - (33.74 if treated with FCR)
