title: Prognostic factors and risk assessment in chronic myelomonocytic leukemia: validation study of the M.D. Anderson Prognostic Scoring System.
abstract: Chronic myelomonocytic leukemia continues to be a poorly understood disease, defined by clinical rather than biological features, with no consensus on optimal therapy. In the past, patients were often assessed for risk using scoring systems developed for other diseases, notably the International Prognostic Scoring System commonly used for myelodysplastic syndrome. The M.D. Anderson Prognostic Scoring System, using hemoglobin, absolute lymphocyte count, peripheral blood immature cells, and bone marrow blasts, was developed specifically for CMML; it was based on retrospective analysis of 213 patients. This report re-examines the validity of this scoring system based on follow-up of the initial cohort and prospectively examines its validity in 250 new patients. Both the original MDAPS system and a modified version derived from data of the initial cohort after extended follow-up (substituting lactate dehydrogenase for bone marrow blasts) effectively stratify both patient cohorts by survival and provide a useful risk assessment tool and additional guidance during treatment decisions.
authors.affiliation: Department of Leukemia, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77230, USA. mberan@mdanderson.org
authors.forename: Miloslav
authors.initials: M
authors.lastname: Beran
authors.forename: Sijin
authors.initials: S
authors.lastname: Wen
authors.forename: Yu
authors.initials: Y
authors.lastname: Shen
authors.forename: Francesco
authors.initials: F
authors.lastname: Onida
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Jelinek
authors.forename: Jorge
authors.initials: J
authors.lastname: Cortes
authors.forename: Francis
authors.initials: F
authors.lastname: Giles
authors.forename: Hagop
authors.initials: H
authors.lastname: Kantarjian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015477:Leukemia, Myelomonocytic, Chronic / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012107:Research Design; D018570:Risk Assessment; D012307:Risk Factors; D016019:Survival Analysis