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 categoryPro­portion of patients (%)Median overall survival (m)
0 - 1Low1826
2Inter­mediate-13214
3Inter­mediate-2399
4High115

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.