Tefferi et al reported a 3-factor model for evaluating a patient with acute myeloid leukemia (AML). The authors are from the Mayo Clinic and MD Anderson Cancer Center.
Patient selection: AML after first therapy
Parameters:
(1) response to chemotherapy
(2) karyotype
(3) age in years
Parameter
Findings
Points
response to chemotherapy
complete response (with or without count recovery)
0
other
2
karyotype
adverse
1
not adverse
0
age in years
<= 55 years
0
> 55 years
1
where:
• Adverse karyotype: complex or monosomal.
• Adverse genetic findings include: adverse karyotype, BCR-ABL1, wild-type NPM1 with high [>=5] allelic ratio FLT3-ITD mutation, TP53, RUNX1, or ASXL1 mutation. Mutations are not included in the score.
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
Total Score
Risk Group
5-Year Survival
0
low
74%
1
intermediate-1
45%
2
intermediate-2
18%
3 or 4
high
< 5%
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