Duval/CIBMTR Score for Acute Myelogenous Leukemia (AML) Survival

Duval/CIBMTR Score for AML Survival

Disease Status

Cytogenetics

Performance Score (Karnofsky)

Donor Type

Age >35 Years

Duval/CIBMTR Score: 0

Best Prognosis

Score 0-2: Best post-transplant survival group. 3-year overall survival ~60-70%.

Predicts overall survival in AML patients with relapsed/refractory disease undergoing myeloablative transplant.

Why Use

Use when deciding between HSCT and additional treatment for patients with relapsed or refractory active disease.

When to Use

Patients with relapsed or refractory active acute myeloid leukemia AML (i.e., NOT in complete remission), for whom myeloablative hematopoietic stem cell transplant (HSCT) is being considered. Do not use in patients with chronic myelogenous leukemia (CML) in blast crisis.

Formula

Addition of the selected points: Variable 0 Points 1 Point 2 Points Disease group Primary induction failure or duration of first complete remission >6 months Duration of first complete remission <6 months -- Cytogenetics prior to HSCT Good or intermediate Poor -- HLA match group HLA identical sibling or well matched or partially matched unrelated Mismatched unrelated Related other than HLA identical sibling Circulating blasts* Absent Present -- Karnofsky or Lansky scale 90-100 <90 -- *At the time of transplant.

Pearls / Pitfalls

Only busulfan and TBI-based regimens were studied in the derivation; reduced-intensity conditioning (RIC) and fludarabine-based regimens were excluded. Syngeneic and cord blood transplants were also not included in this analysis.

Management

HSCT should be considered in patients with scores ≤2 in the context of other available therapies, given their predicted OS of 15-46%.

Critical Actions

Risk should be discussed with the patient.

Advice

High-risk patients with 3-year overall survival (OS) of 6% should be counseled and preferably referred for relapse-mitigation clinical trials.

More Information

Interpretation: Duval Score 3-year overall survival after transplantation 0 42% 1 28% 2 15% ≥3 6% From Duval 2010 .