Proposed modified International Working Group response criteria for hematologic improvement7
Hematologic improvement* . | Response criteria (responses must last at least 8 wk)† . |
|---|---|
| Erythroid response (pretreatment, < 11 g/dL) | Hgb increase by ≥ 1.5 g/dL |
| Relevant reduction of units of RBC transfusions by an absolute number of at least 4 RBC transfusions/8 wk compared with the pretreatment transfusion number in the previous 8 wk. Only RBC transfusions given for a Hgb of ≤ 9.0 g/dL pretreatment will count in the RBC transfusion response evaluation† | |
| Platelet response (pretreatment, < 100 × 109/L) | Absolute increase of ≥ 30 × 109/L for patients starting with > 20 × 109/L platelets |
| Increase from < 20 × 109/L to > 20 × 109/L and by at least 100%† | |
| Neutrophil response (pretreatment, < 1.0 × 109/L) | At least 100% increase and an absolute increase > 0.5 × 109/L† |
| Progression or relapse after HI‡ | At least 1 of the following: |
| At least 50% decrement from maximum response levels in granulocytes or platelets | |
| Reduction in Hgb by ≥ 1.5 g/dL | |
| Transfusion dependence |
Hematologic improvement* . | Response criteria (responses must last at least 8 wk)† . |
|---|---|
| Erythroid response (pretreatment, < 11 g/dL) | Hgb increase by ≥ 1.5 g/dL |
| Relevant reduction of units of RBC transfusions by an absolute number of at least 4 RBC transfusions/8 wk compared with the pretreatment transfusion number in the previous 8 wk. Only RBC transfusions given for a Hgb of ≤ 9.0 g/dL pretreatment will count in the RBC transfusion response evaluation† | |
| Platelet response (pretreatment, < 100 × 109/L) | Absolute increase of ≥ 30 × 109/L for patients starting with > 20 × 109/L platelets |
| Increase from < 20 × 109/L to > 20 × 109/L and by at least 100%† | |
| Neutrophil response (pretreatment, < 1.0 × 109/L) | At least 100% increase and an absolute increase > 0.5 × 109/L† |
| Progression or relapse after HI‡ | At least 1 of the following: |
| At least 50% decrement from maximum response levels in granulocytes or platelets | |
| Reduction in Hgb by ≥ 1.5 g/dL | |
| Transfusion dependence |
Deletions to the IWG response criteria are not shown.
To convert hemoglobin levels from grams per deciliter to grams per liter, multiply grams per deciliter by 10.
Hgb indicates hemoglobin; RBC: red blood cell; HI: hematologic improvement.
Pretreatment counts averages of at least 2 measurements (not influenced by transfusions) ≥ 1 week apart (modification).
Modification to IWG response criteria.
In the absence of another explanation, such as acute infection, repeated courses of chemotherapy (modification), gastrointestinal bleeding, hemolysis, and so forth. It is recommended that the 2 kinds of erythroid and platelet responses be reported overall as well as by the individual response pattern.