MF 風險分類

風險分類 - 如何計算以判斷骨髓纖維化MF的嚴重程度?

要計算骨髓纖維化的嚴重程度,可利用兩個計分準則,分別是國際預後評分系統(Dynamic International Prognostic Scoring System;DIPSS),以及DIPSS-PLUS風險分類系統,來綜合評估骨髓纖維化的4個程度等級,即低風險、中度風險-1、中度風險-2,或高風險。⁷

評分步驟一:

先按以下DIPSS所列的風險因素,相加各項分數而得出一個總分數:⁷

風險因素 0分 1分 2分
年紀 ≤65歲 >65歲 /
白血球數量 ≤25× 10⁹/dL
>25× 10⁹/dL /
血紅蛋白 ≥10g/dL
/ <10g/dL
循環原始細胞 <1%
≥1% /
全身症狀
/

評分步驟二:

把DIPSS的總分數按下列表格,轉換成DIPSS-PLUS分數:⁷

DIPSS總分數 0 1-2 2-3 3-4
DIPSS-PLUS分數 0分 1分 2分 3分

評分步驟三:

在DIPSS-PLUS 分數上,再按下列表格列出的三項其他因素,加0-3分不等而得出一個總數:⁷

其他因素 以下每項+1分
預後較差的基因類型,例如複雜核型或以下的基因類型:
+8, -7/7q-, i(17q), -5/5q-, 12p-, inv(3) 11q23
血小板數量 <100 X 10⁹ /dL
因貧血而需要接受輸血

評分步驟四:

評分步驟四:
根據DIPSS-PLUS總分數,可把骨髓纖維化的嚴重程度分類為:⁷

>DIPSS-PLUS總分數 0 1 2-3 3-4
風險等級 低風險疾病 中度風險-1 中度風險-2 高風險疾病

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