Refractory anemia with excess of blasts (RAEB)補助診断のための点数方式

抄録

The cooperative study group on “Preleukemia” supported by Grant in-Aid for Cancer Research from the Ministry of Health and Welfare, Japan, designated “refractory anemia with excess of blasts” as one of the project studies in 1980, with the views of clarifing whether patients with RAEB exist in Japan as well as Europe and whether they, if exist, have any particular clinical findings, and of establishing a scoring method for distinguishing RAEB from other hematological diseases.
Clinical records of suspected RAEB, which had been conceived by Dreyfus, were collected by every member of the study group. This investigation proved the existence of RAEB patients in Japan. Clinical and laboratory findings of fifty eight cases were analysed for the scoring method. The following 13 items were picked up for the criteria and were respectively given scores according to their significance;
as bone marrow findings
1) nucleated cell count more than 50×10⁹/L score 12
2) 7 to 30% of blasts plus promyelocytes score 12
3) steady state of bone marrow findings more than 6 months score 12
4) 10 to 50% of erythroblasts score 8
5) more than 15% of myelocytes+metamyelocytes+bands+segmented neutrophils score 8
6) less than 20% of lymphocytes score 8
7) morphological abnormalities more than two series in bone marrow elements score 8
as peripheral blood findings
8) more than 50×10⁹/L of platelets score 8
9) more than 0.5×10⁹/L of neutrophil counts score 4
10) less than 5% of immature granulocytes score 4
11) less than 60% of lymphocytes score 4
12) more than 180 of neutrophil AP score score 4
13) age older than 50 score 8
The patients with scores 90 to 100 in total were regarded as definite RAEB, scores 80 to 89 probable RAEB, scores 70 to 79 possible RAEB, and scores less than 69 impossible. The scoring method was applied to other hematological disorders and revealed that the patients with leukemia of M1, M2, M3, M4, or M5 types according to FAB classification and those with aplastic anemia had scores less than 69 without any exception. However, scores of some cases with M6 and primary acquired sideroblastic anemia ranged from 70 to 76.
From these results, the scoring method is presented as to be instrumental in making the diagnosis of RAEB as a supportive means.