Table 5 Calculating Child–Pugh status and everolimus dosage recommendations [19, 55]

Factor

1 point

2 points

3 points

 Total bilirubin (μmol/L)

<34

34–50

>50

 Serum albumin (g/L)

>35

28–35

<28

 PT INR

<1.7

1.71–2.30

>2.30

 Ascites

None

Mild to moderate

Severe/refractory

 Hepatic encephalopathy

None

Grade I–II (or suppressed with medication)

Grade III–IV (or refractory)

Child–Pugh class

Class A

Class B

Class C

 Total points

5–6

7–9

10–15

Recommendation in patients with AML

The recommended dose is 7.5 mg daily

The recommended dose is 5 mg daily

Everolimus is only recommended if the desired benefit outweighs the risk; a dose of 2.5 mg daily must not be exceeded

Recommendation in patients with SEGA

75% of the recommended starting dose, calculation based on BSA (rounded to the nearest strength)

25% of the recommended starting dose, calculation based on BSA (rounded to the nearest strength)

Everolimus is not recommended