Predictive Aplastic Score System (PASS)
Adjunctive score to help distinguish adult acquired aplastic anemia from inherited bone marrow failure syndromes.
Answer questions 1-5 to generate a PASS score. Questions 6-7 are optional but recommended for best performance when somatic genetic or telomere data are available.
Required features
Severe/very severe aplastic anemia requires at least 2 of: ANC <0.5 x 10^9/uL, platelets <20 x 10^3/uL, or absolute reticulocyte count <60 x 10^3/uL with hemoglobin <10 g/dL.
Red flags include congenital or dysmorphic features, interstitial lung disease, avascular necrosis, unexplained cirrhosis, mucocutaneous triad, unexpected hematologic toxicity after chemotherapy or radiation, refractory warts or non-TB mycobacterial infection, head and neck or anogenital squamous cancer, or an affected first-degree relative.
Examples include seronegative autoimmune hepatitis, immune checkpoint inhibitor treatment, immune dysregulation syndromes, eosinophilic fasciitis, thymoma, Hodgkin lymphoma, or prior tolerance of cytotoxic chemotherapy without unexpected hematologic toxicity.
Recommended for best performance
Includes >=0.5% granulocyte PNH clone, 6p LOH, somatic BCOR or BCORL1 mutation, or del(13q).