Clinical calculator summary
Original 2000 Sanz APL relapse-risk classification
Clinical calculator summary
Original 2000 Sanz APL relapse-risk classification
A three-group baseline APL classification using presentation WBC and platelet thresholds.
Evidence-based context for fast calculator use
- Purpose:
- Reproduce the original PETHEMA/GIMEMA relapse-risk grouping without converting it into a treatment recommendation.
- Population:
- Newly diagnosed, molecularly confirmed APL assessed using presentation or pretreatment blood counts.
- Factors:
- Presentation WBC, Presentation platelet count, Strict >10 and >40 thresholds
- Reference:
- Sanz et al. Blood. 2000;96(4):1247-1253. doi:10.1182/blood.V96.4.1247.
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SANZ Risk Score (APL)
x10^9/L
x10^9/L
Clinical Context & Background
This calculator reproduces the original 2000 PETHEMA/GIMEMA Sanz relapse-risk classification. It uses raw presentation or pretreatment WBC and platelet counts, without rounding, in newly diagnosed molecularly confirmed acute promyelocytic leukemia (APL).
It is a historical three-group relapse-risk classification from an ATRA/anthracycline treatment-era cohort. It is not a modern two-group treatment algorithm, an early-death model, a general AML calculator, a surveillance tool, or a post-treatment reclassification system. A treatment-related rise in WBC must not be used to change the baseline Sanz group.
Suspected APL is a medical emergency. Calculation must not delay immediate specialist assessment and management.
Formula Logic
Original 2000 Sanz classification using presentation/pretreatment counts (x10^9/L): High Risk when WBC >10; otherwise Low Risk when platelets >40; otherwise Intermediate Risk. Raw unrounded values are used.Reference Data
| Risk Group | Original 2000 criteria | Model meaning |
|---|---|---|
| Low Risk | WBC ≤10 AND platelets >40 x10^9/L | Original relapse-risk group |
| Intermediate Risk | WBC ≤10 AND platelets ≤40 x10^9/L | Original relapse-risk group |
| High Risk | WBC >10 x10^9/L, regardless of platelets | Original relapse-risk group |
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
Clinical Workflow
Use, Interpret, And Continue The Patient Pathway
Expand for workflow guidance, limitations, examples, and related next steps.
When To Use
- Use only at initial presentation in newly diagnosed, molecularly confirmed APL.
- Enter raw unrounded pretreatment WBC and platelet counts in x10^9/L.
How To Interpret
- WBC >10 defines High Risk regardless of platelets.
- When WBC is ≤10, platelets >40 define Low Risk; platelets ≤40 define Intermediate Risk.
What To Do Next
- Suspected APL is a medical emergency. Calculation must not delay immediate specialist assessment and management.
- Interpret the historical group alongside current specialist guidance; the calculator does not select a regimen.
Limitations
- Not for general AML, early-death prediction, surveillance, relapse, or post-treatment assessment.
- Do not reclassify using a treatment-related WBC increase.
- Historical cohort associations are not individualized prognosis or treatment recommendations.
Validated Population
217 newly diagnosed PML/RAR-alpha-positive APL patients in the original PETHEMA/GIMEMA cohorts.
Calculation verification history
Verified
Calculation verification history
Verified: Production browser revalidation
- Three source-backed Sanz APL cases passed through visible production controls across Low, Intermediate, and High groups.
- No unexpected N/A, literal undefined value, stale control, unsupported gauge, or browser-console error was observed.
Case-level evidence is retained in validation/browser-revalidation/sanz-apl-acute-promyelocytic-leukemia-risk-2026-08-03.json.
: Production browser validation
- Ten source-backed cases were exercised on the public production route through visible browser controls; 10/10 case records passed their expected-versus-observed assertions across 11 visible submissions.
- Overall browser status: failed-console. medium: Production emitted minified React error #418 during route loads/reloads used by this run.
- Case-level inputs, expected and observed results, reset/repeat behavior, failure reproductions, and console evidence are retained in the production-browser evidence record.
Case-level production evidence is retained in validation/browser-production/sanz-apl-acute-promyelocytic-leukemia-risk.json.
: Browser input adapter corrected and reverified
- Accepted finite number values already normalized by the shared calculator form while retaining strict malformed-input rejection.
- No equation, cutoff, unit, classification, or applicability rule changed; calculator-specific verification and the calculator-wide browser-input audit passed.
: Full validation test
- 320/320 source-rule, exact-boundary, strict-input, trace, immutability, UI, and presentation checks passed with zero difference.
- Scope is the original 2000 three-group baseline relapse-risk classification; no panel calculates Sanz or inherits this status.
: Calculation and input-contract correction
- Locked exact raw boundaries: WBC >10 is High Risk; otherwise platelets >40 is Low Risk and platelets <=40 is Intermediate Risk.
- Removed numeric coercion, incomplete or extra input acceptance, integer-only platelet entry, regimen recommendations, and Standard of Care table wording.
- Added baseline-count scope, decision trace, matched row, immutable snapshot, and urgent suspected-APL warning.
Verification confirms the calculator implementation against the cited model; it is not independent clinical validation, regulatory approval, or medical advice.
Frequently Asked Questions
When should SANZ Risk Score (APL) be used?
Use it for patients with the specific hematologic diagnosis and disease phase described by the model when all required inputs and the intended clinical setting are confirmed.
Can SANZ Risk Score (APL) determine treatment by itself?
No. Interpret the result with the cited evidence, complete clinical assessment, current guidelines, and patient-specific goals.
Evidence-based oncology decision support. Verify with clinical guidelines.