The clinical and laboratory findings in a patient with acute
leukemia can be graded using the rating criteria listed by Kurtzberg et al.
This can be used to monitor the changes following chemotherapy.
NOTE: The grading scheme can be applied to patients with
either ALL or AML.
|
Parameters
|
Findings
|
Rating
|
|
symptoms
|
asymptomatic
|
1
|
|
|
moderately symptomatic
|
2
|
|
|
markedly symptomatic
|
3
|
|
performance
|
ECOG 0 and 1 (normal activity)
|
1
|
|
|
ECOG 2 (< 50% of time in bed)
|
2
|
|
|
ECOG 3 and 4 (>= 50% of time in bed)
|
3
|
|
liver on physical examination
|
normal for age
|
1
|
|
|
down to umbilicus
|
2
|
|
|
below umbilus
|
3
|
|
spleen on physical examination
|
normal for age
|
1
|
|
|
abnormal
|
2
|
|
|
grossly visible
|
3
|
|
other findings on physical examination
|
normal for age
|
1
|
|
|
definite
|
2
|
|
|
marked
|
3
|
|
hemoglobin
|
age < 2 years and >= 10 g/dL
|
1
|
|
|
age < 2 years and 7 - 9.9 g/dL
|
2
|
|
|
age >= 2 years and >= 11 g/dL
|
1
|
|
|
age >= 2 years and 7 - 10.9 g/dL
|
2
|
|
|
< 7 g/dL
|
3
|
|
absolute neutrophil count
|
> 1,500 per µL
|
1
|
|
|
500 to 1,500 per µL
|
2
|
|
|
< 500 per µL
|
3
|
|
percent blasts in peripheral blood differential
|
0
|
1
|
|
|
0.1% to 5%
|
2
|
|
|
> 5%
|
3
|
|
platelet count
|
> 100,000 per µL
|
1
|
|
|
25,000 to 100,000 per µL
|
2
|
|
|
< 25,000 per µL
|
3
|
|
percent blasts in the bone marrow
|
<= 5%
|
1
|
|
|
6 - 25%
|
2
|
|
|
> 25%
|
3
|
• I rated mild symptoms (not listed) as 2.