Duval/CIBMTR Score for AML in Second Complete Remission
Predicts probability of achieving second complete remission (CR2) and survival after first relapse of AML.
Score interpretation
Score 0: CR2 probability ~46%. Best prognosis for relapsed AML.
→ Intensive salvage chemotherapy (e.g. MEC, FLAG-Ida). Proceed to allogeneic SCT if CR2 achieved.
Score 1: CR2 probability ~29%.
→ Salvage chemotherapy. Clinical trial preferred. SCT planning if CR2 achieved.
Score 2: CR2 probability ~14%.
→ Clinical trial enrolment strongly recommended. Novel agents (venetoclax-based). Discuss SCT feasibility.
Score 3–4: CR2 probability ~5%. Very poor prognosis.
→ Clinical trial is the preferred approach. Careful goals-of-care discussion. Palliative measures may be appropriate.
Interpretation bands for the Duval AML. Apply clinical judgement and local guidance.
References
- Duval M et al. Hematopoietic Stem-Cell Transplantation for Acute Leukemia in Relapse or Primary Induction Failure. J Clin Oncol. 2010;28(23):3730-3738.
Related
Curated clinical cross-links plus same-class fallbacks.
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Dobutamine (Acute HF / Stress Echo) · Inotrope / Acute Heart Failure
- Milrinone · Inodilator / Acute Heart Failure
- Prednisolone (Systemic) · Systemic Corticosteroid — Acute Dermatoses
- Phenytoin / Fosphenytoin · Antiepileptic — Status Epilepticus (Second-Line)
- Levetiracetam (IV) · Antiepileptic — Status Epilepticus (Second-Line)
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.