Hematology · LIVE

BALL score for relapsed-refractory CLL

BALL score

Sum the four Soumerai 2019 BALL flags for relapsed or refractory CLL and return score 0–4 with risk low (0–1), intermediate (2–3), or high (4).

LIVE $0.005 USDC GET /api/calc/ball

Markdown: /docs/ball.md · Canonical: https://magentlab.com/docs/ball

Not a medical device. Not a diagnosis, dose, or listing recommendation.

What it computes

Sum the four Soumerai 2019 BALL flags for relapsed or refractory CLL and return score 0–4 with risk low (0–1), intermediate (2–3), or high (4).

When to use

When an agent already has caller-assigned Soumerai 2019 BALL flags and needs the published 0–4 total and risk band, not a CLL treatment recommendation, lab assay, or invented overall-survival percent.

When not to use

• Not a medical device and not a treatment recommendation. magent does not assay labs.
• b2m_ge_5 is a caller-assigned flag. The paper’s cutoff string is ≥5 mg/dL (Lancet Haematol 2019 abstract). Some later summaries print mg/L; magent does not convert mg/L versus mg/dL and does not assay β2-microglobulin.
• anemia is a caller-assigned flag using hemoglobin <110 g/L in women or <120 g/L in men. magent does not take a hemoglobin number or sex.
• ldh_gt_uln and last_therapy_lt_24mo are caller-assigned flags. magent does not assay LDH or read a treatment calendar.

Formula

BALL = b2m_ge_5 + ldh_gt_uln + anemia + last_therapy_lt_24mo; each 1; Soumerai 2019; max 4; low 0-1, intermediate 2-3, high 4

Citation

Title

Prognostic risk score for patients with relapsed or refractory chronic lymphocytic leukaemia treated with targeted therapies or chemoimmunotherapy: a retrospective, pooled cohort study with external validations

Authors

Soumerai JD, Ni A, Darif M, Londhe A, Xing G, Mun Y, et al.

Source

Lancet Haematol. 2019;6(7):e366-e374

DOI

10.1016/S2352-3026(19)30085-7

Worked example

Also searched as

• BALL score
• BALL CLL
• Soumerai BALL
• relapsed refractory CLL score
• BALL prognostic score
• beta-2-microglobulin CLL score
• R/R CLL BALL

Try

Opens the live endpoint. Unpaid browser requests show the paywall; agents should send Accept: application/json.

/api/calc/ball?b2m_ge_5=false&ldh_gt_uln=false&anemia=false&last_therapy_lt_24mo=false

Full URL: https://api.magentlab.com/api/calc/ball?b2m_ge_5=false&ldh_gt_uln=false&anemia=false&last_therapy_lt_24mo=false

Call

Expect HTTP 402 until you retry with PAYMENT-SIGNATURE. Incomplete query params return HTTP 400 before any quote or charge.

curl -i -H "Accept: application/json" "https://api.magentlab.com/api/calc/ball?b2m_ge_5=false&ldh_gt_uln=false&anemia=false&last_therapy_lt_24mo=false"

Parameters

Bulk (POST)

POST the same path with a JSON items array. The first item is the GET unit; each additional item is $0.002. Invalid items return HTTP 400 before settlement.

POST /api/calc/ball Max 25 unit_amount + extra_item_amount * (n - 1) extra $0.002 PREVIEW

• 1 to 25 items. Each item uses the same keys as the GET query parameters.
• POST of 1 item costs the same as GET. Lists longer than 25: chunk into multiple POSTs. Extra items still execute; do not pad dummy rows.
• The first invalid item fails the whole request (index in the 400 JSON). You are not charged.
• HTTP 200 is {count, path, items}. Each items[i] is the GET 200 body for that row.
• Catalog misses (empty matches, found=false) stay paid 200s inside that slot.
• x402 resource URL is this path plus n and body_sha256. Browsers that prefer text/html get the same paywall as GET; Pay retries POST with the same items.

Example request (fixture)

{
  "items": [
    {
      "anemia": "false",
      "b2m_ge_5": "false",
      "last_therapy_lt_24mo": "false",
      "ldh_gt_uln": "false"
    },
    {
      "anemia": "false",
      "b2m_ge_5": "false",
      "last_therapy_lt_24mo": "false",
      "ldh_gt_uln": "false"
    }
  ]
}

Open bulk paywall →

Opens a two-item fixture on the API host. Unpaid browsers get the same MetaMask paywall as GET; Pay retries POST with those items.

Example 200 (fixture)

{
  "count": 2,
  "path": "/api/calc/ball",
  "items": [
    {
      "components": [
        {
          "factor": "b2m_ge_5",
          "points": 0,
          "present": false
        },
        {
          "factor": "ldh_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "anemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "last_therapy_lt_24mo",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Soumerai JD, Ni A, Darif M, Londhe A, Xing G, Mun Y, et al.",
        "doi": "10.1016/S2352-3026(19)30085-7",
        "id": "soumerai-2019",
        "pmid": "31109827",
        "source": "Lancet Haematol. 2019;6(7):e366-e374",
        "title": "Prognostic risk score for patients with relapsed or refractory chronic lymphocytic leukaemia treated with targeted therapies or chemoimmunotherapy: a retrospective, pooled cohort study with external validations"
      },
      "formula": "ball",
      "formula_expression": "BALL = b2m_ge_5 + ldh_gt_uln + anemia + last_therapy_lt_24mo; each 1; Soumerai 2019; max 4; low 0-1, intermediate 2-3, high 4",
      "max_score": 4,
      "score": 0,
      "risk": "low"
    },
    {
      "components": [
        {
          "factor": "b2m_ge_5",
          "points": 0,
          "present": false
        },
        {
          "factor": "ldh_gt_uln",
          "points": 0,
          "present": false
        },
        {
          "factor": "anemia",
          "points": 0,
          "present": false
        },
        {
          "factor": "last_therapy_lt_24mo",
          "points": 0,
          "present": false
        }
      ],
      "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
      "citation": {
        "authors": "Soumerai JD, Ni A, Darif M, Londhe A, Xing G, Mun Y, et al.",
        "doi": "10.1016/S2352-3026(19)30085-7",
        "id": "soumerai-2019",
        "pmid": "31109827",
        "source": "Lancet Haematol. 2019;6(7):e366-e374",
        "title": "Prognostic risk score for patients with relapsed or refractory chronic lymphocytic leukaemia treated with targeted therapies or chemoimmunotherapy: a retrospective, pooled cohort study with external validations"
      },
      "formula": "ball",
      "formula_expression": "BALL = b2m_ge_5 + ldh_gt_uln + anemia + last_therapy_lt_24mo; each 1; Soumerai 2019; max 4; low 0-1, intermediate 2-3, high 4",
      "max_score": 4,
      "score": 0,
      "risk": "low"
    }
  ]
}

Response

Example JSON

Machine form of the same example. Frozen fixture. Not a live lookup.

{
  "components": [
    {
      "factor": "b2m_ge_5",
      "points": 0,
      "present": false
    },
    {
      "factor": "ldh_gt_uln",
      "points": 0,
      "present": false
    },
    {
      "factor": "anemia",
      "points": 0,
      "present": false
    },
    {
      "factor": "last_therapy_lt_24mo",
      "points": 0,
      "present": false
    }
  ],
  "disclaimer": "Not a medical device. Deterministic published-formula or published-code output for autonomous agents. A licensed clinician remains responsible for patient care and billing submissions.",
  "citation": {
    "authors": "Soumerai JD, Ni A, Darif M, Londhe A, Xing G, Mun Y, et al.",
    "doi": "10.1016/S2352-3026(19)30085-7",
    "id": "soumerai-2019",
    "pmid": "31109827",
    "source": "Lancet Haematol. 2019;6(7):e366-e374",
    "title": "Prognostic risk score for patients with relapsed or refractory chronic lymphocytic leukaemia treated with targeted therapies or chemoimmunotherapy: a retrospective, pooled cohort study with external validations"
  },
  "formula": "ball",
  "formula_expression": "BALL = b2m_ge_5 + ldh_gt_uln + anemia + last_therapy_lt_24mo; each 1; Soumerai 2019; max 4; low 0-1, intermediate 2-3, high 4",
  "max_score": 4,
  "score": 0,
  "risk": "low"
}

Client errors (HTTP 400)

Invalid params return 400 without charge. Shared HTTP 402 and 503 meanings: Payments.

Related tools

• IPI — Sum the Shipp 1993 five-factor International Prognostic Index (all ages) and return low (0–1), low_intermediate (2), high_intermediate (3), or high (4–5).

Payment

Unpaid requests return HTTP 402 even if query parameters or POST items are missing or invalid, so CDP and agents can index the path. After a PAYMENT-SIGNATURE, invalid params return HTTP 400 JSON before settlement. magent does not charge. Fix the params, then request a new 402 quote for that complete URL. Catalog misses (empty matches, found=false) are valid paid 200s. Unpaid valid requests return HTTP 402 with a base64 PAYMENT-REQUIRED header. HTTP 503 is not a new quote: retry the same PAYMENT-SIGNATURE. Full handshake and shared payment errors: Payments. Stdio MCP: /docs/mcp.

Guarantees

• HTTP 402 is unpaid, including a missing query. After PAYMENT-SIGNATURE, invalid parameters return HTTP 400 before settlement. You are not charged. HTTP 402 never includes the tool JSON.
• exact: settlement finishes before the tool (paymentFlow upfront). batch-settlement: verify/deposit before the tool; chargedCumulativeAmount commits after HTTP 2xx. Uncertain or failed settlement fails closed (HTTP 503). Retry the same PAYMENT-SIGNATURE.
• HTTP 402 is unpaid only. Do not sign a second authorization because of a 503.
• Execution is timeout-bounded and concurrency-capped.
• Calculator inputs are stored encrypted for allowlisted operators (Magent Console). They are not in public logs, SSH lookups, catalog, or rollups. Request logs store path without query.