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    Patent Pending

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

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

    Use in patients with relapsed or refractory active AML for whom hematopoietic stem cell transplant (HSCT) is being considered. Do not use in patients with chronic myelogenous leukemia (CML) in blast crisis.

    When to Use
    Pearls/Pitfalls
    Why 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.

    • 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.

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

    Primary induction failure or duration of first complete remission >6 months
    0
    Duration of first complete remission <6 months
    +1
    Good or intermediate
    0
    Poor
    +1
    HLA identical sibling or well matched or partially matched unrelated
    0
    Mismatched unrelated
    +1
    Related other than HLA identical sibling
    +2
    Absent
    0
    Present
    +1
    90-100
    0
    <90
    +1

    Result:

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    Next Steps
    Evidence
    Creator Insights

    Advice

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

    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.

    Content Contributors
    • Joseph Maakaron, MD
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    About the Creator
    Dr. Michel Duval
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    Content Contributors
    • Joseph Maakaron, MD