PROGNOSTIC FACTORS IN AGNOGENIC MYELOID METAPLASIA - A REPORT ON 195 CASES WITH A NEW SCORING SYSTEM

We studied the survival of 195 patients with agnogenic myeloid metapla sia (AMM) diagnosed between 1962 and 1992 in an attempt to stratify pa tients into risk groups. Median survival was 42 months. Adverse progno stic factors for survival were age > 60 years, hepatomegaly, weight lo ss, low hemoglobin level (Hb), low or very high leukocyte count (WBC), high percentage of circulating blasts, male sex, and low platelet cou nt. A new scoring system based on two adverse prognostic factors, name ly Hb < 10 g/dL and WBC < 4 or > 30 x 10(9)/L, was able to separate pa tients in three groups with low (0 factor), intermediate (1 factor), a nd high (2 factors) risks, associated with a median survival of 93, 26 , and 13 months, respectively. An abnormal karyotype (32 cases of 94 t ested patients) was associated with a short survival, especially in th e low-risk group (median survival of 50 v 112 months in patients with normal karyotype). The prognostic factors for acute conversion were WB C > 30 x 10(9)/L and abnormal karyotype. Thus, hemoglobin level and le ukocyte count provide a simple prognostic model for survival in AMM, a nd the adverse prognostic value of abnormal karyotype may be related t o a higher rate of acute conversion. (C) 1996 by The American Society of Hematology.