MD Anderson Prognostic Scoring System (MDAPS)
Prognostic score for chronic myelomonocytic leukemia (CMML)
1. Sum the number of risk factors present
- Hemoglobin < 12 g/dL
- Lymphocyte count > 2.5 x10^9/L
- Peripheral blood immature myeloid cells > 0%
- Bone marrow blasts ≥ 10%
2. Determine risk category and prognosis
|Risk factors (n)||Risk category||Proportion of patients (%)||Median overall survival (m)|
|0 - 1||Low||18||26|
The MD Anderson Prognostic Scoring System (MDAPS) for CMML1 was based upon multivariate analysis of survival of 213 patients diagnosed between 1966 and 1999. Patients received a wide range of treatments, including hematopoietic growth factors, cytokines and low- and high-dose chemotherapies.
The MDAPS was validated in a cohort of 250 patients seen from 2003 to 2005 at the same institution.2 A modification to the original MDAPS prognostic system was proposed, replacing the presence of peripheral blood immature myeloid cells as a risk factor with raised LDH > 700 U/L. This modification (termed MDAPS-M1) yields similar median overall survival times of 26, 16, 10 and 5 months for low, intermediate-1, intermediate-2 and high risk groups, respectively.
- Onida F, Kantarjian HM, Smith TL, Ball G, Keating MJ, Estey EH et al. Prognostic factors and scoring systems in chronic myelomonocytic leukemia: a retrospective analysis of 213 patients. Blood 2002; 99: 840-849.
- Beran M, Wen S, Shen Y, Onida F, Jelinek J, Cortes J et al. Prognostic factors and risk assessment in chronic myelomonocytic leukemia: validation study of the M.D. Anderson Prognostic Scoring System. Leuk Lymphoma 2007; 48: 1150-1160.