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Old Tue Jan 4, 2011, 10:43 PM
Greg H Greg H is offline
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Join Date: Sep 2010
Location: North Carolina
Posts: 660
Karyotype Ratings

Hey Neil!

While Margarete's issue may be more of a technical computer issue, I thought I'd take the opportunity of this tread to weigh in on a more substantive issue with the tool, which I think is a very fine idea on the whole.

For the moment, I'm only interested in the IPSS portion, since that seems to be the basic tool that most docs, patients, and NGOs like to reference.

If I enter my current stats, I have three cytopenias, which gets me a half point, and less than five percent blasts, which nets a zero. So far, so good.

If I then crank in my Trisomy 8, I pick up a full point, and get an INT-2 score. I'm not sure if this is a mistake or based on some evaluation of Trisomy 8 as a "Poor" Karyotype. The NCCN Guidelines on MDS offer the following guidance on karyotype: "Cytogenetics: Good = normal, -Y alone, del(5q) alone, del(20q) alone; Poor = complex (>=3 abnormalities) or chromosome 7 anomalies; Intermediate = other abnormalities. [This excludes karyotypes t(8;21), inv16, and t(15;17), which are considered to be AML not MDS.]"

No specific mention of Trisomy 8, so it gets an "intermediate" half point. I am betting the tool is relying on some other resource to score cytogenetics. Can you fill me in?

I'm aware that the question of how to rate cytogenetics may be an area of some disagreement amongst researchers, because I have seen other breakdowns than the one cited above. I can offer that each of the docs I have consulted has rated me INT-1, considering Trisomy 8 an "intermediate risk" karyotype and awarding me half a point in that category for my trouble.

Thanks and Happy New Year!

Greg
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Greg, 59, dx MDS RCMD Int-1 03/10, 8+ & Dup1(q21q31). NIH Campath 11/2010. Non-responder. Tiny telomeres. TERT mutation. Danazol at NIH 12/11. TX independent 7/12. Pancreatitis 4/15. 15% blasts 4/16. DX RAEB-2. Beginning Vidaza to prep for MUD STC. Check out my blog at www.greghankins.com
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