Bone Marrow Score

This website was developed to provide an accurate and user-friendly calculation of the Bone Marrow (BM) score. The BM score comprises 7 clinical and laboratory parameters. Positive findings are summated into a total score. For adult patients with fever of unknown origin (FUO), or unexplained fever, the BM score estimates the risks of (1) underlying hematological diseases in the BM [1], and (2) the presence and/or development of hemophagocytic lymphohistiocytosis (HLH) [2]. Early recognition of patients at higher risks and prompt actions including BM study is important.

This information can only be used by experienced physicians. The BM score is NOT appropriate for these patients, including

  1. <18 years-old,
  2. Known human immuno-deficiency virus (HIV) infection,
  3. Recipients of a solid organ transplant,
  4. Active immunosuppressive therapy,
  5. History of malignant hematological disease,
  6. Neutropenic (white blood cell count [WBC] <1000/mL, or an absolute neutrophil count [ANC] <500/mL) before the onset of fever,
  7. Hypogammaglobulinemic (immunoglobulin G <50%).
Using The Calculator

Click below on the Calculator link to proceed to the Bone Marrow Score calculator.

Calculator
References
  1. Wang HY, Yang CF, Chiou TJ, Yang SH, Gau JP, Yu YB, Liu CY, Liu JH, Chen PM, Hsu HC, Fung CP, Tzeng CH, Hsiao LT.* A "bone marrow score" for predicting hematological disease in immunocompetent patients with fevers of unknown origin. Medicine (Baltimore). 2014 Dec;93(27):e243. PubMed
  2. Wang HY, Yang CF, Chiou TJ, Yang SH, Gau JP, Yu YB, Chen PM, Hsu HC, Fung CP, Lin HY, Tzeng CH, Liu JH, Hsiao LT.* Risk of hemophagocytic lymphohistiocytosis in adults with fevers of unknown origin: the clinical utility of a new scoring system on early detection. Hematol Oncol. 2017 Dec;35(4):835-844. doi: 10.1002/hon.2333. Epub 2016 Jul 28. PubMed
  3. Wang HY,* Yang CF, Chiou TJ, Gau JP, Chen PM, Tsai CY, Hsu HC, Wang FD, Liu JH, Hsiao LT.* Primary bone marrow lymphoma: A hematological emergency in adults with fever of unknown origin. Cancer Med. 2018 Aug;7(8):3713-3721. doi:10.1002/cam4.1669. Epub 2018 Jul 9. PubMed
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