Fotios V Michelis1, Hans A Messner1, Jieun Uhm1, Naheed Alam1, Anna Lambie1, Laura McGillis1, Matthew D Seftel1, Vikas Gupta1, John Kuruvilla1, Jeffrey H Lipton1, Dennis Dong Hwan Kim2. 1. Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. 2. Allogeneic Blood and Marrow Transplant Program, Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada. Electronic address: dr.dennis.kim@uhn.ca.
Abstract
INTRODUCTION: Risk scores have been developed for allogeneic hematopoietic cell transplantation (HCT) outcomes, such as the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) and the modified European Group for Blood and Marrow Transplantation risk score (mEBMT) for acute leukemia. We investigated the influence of these scores for 350 patients who underwent transplantation for acute myeloid leukemia (AML). PATIENTS AND METHODS: The HCT-CI scores were grouped as 0 to 2 and ≥ 3 (231 and 119 patients, respectively) and the mEBMT scores as 0 to 2 and ≥ 3 (166 and 184 patients, respectively). RESULTS: Univariate analysis showed a significant association between the HCT-CI score and overall survival (OS) (P = .01), as did the mEBMT score (P = .002). The 5-year OS rate was 50% and 34% for a mEBMT score of 0 to 2 and ≥ 3, respectively. A subgroup of patients with a mEBMT score of 0 to 1 (n = 32) demonstrated a favorable OS of 75% at 5 years. This subgroup was younger (median age, 31 years), in first remission at transplantation, and had related donors. For the HCT-CI, the 5-year OS was 46% and 34% for a score of 0 to 2 and ≥ 3, respectively. Patients with an HCT-CI score of 0 (n = 94) had a 5-year OS of 44%. Multivariable analysis confirmed both the HCT-CI score and the mEBMT score, as previously grouped, as independent prognostic variables for both OS (P = .02 and P = .001, respectively) and nonrelapse mortality (NRM) (P = .01 and P = .003, respectively). CONCLUSION: The results of the present study have demonstrated that the HCT-CI and mEBMT are both prognostic for OS and NRM in our cohort. However, the mEBMT score can identify a favorable-risk subgroup of patients not identifiable using the HCT-CI.
INTRODUCTION: Risk scores have been developed for allogeneic hematopoietic cell transplantation (HCT) outcomes, such as the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) and the modified European Group for Blood and Marrow Transplantation risk score (mEBMT) for acute leukemia. We investigated the influence of these scores for 350 patients who underwent transplantation for acute myeloid leukemia (AML). PATIENTS AND METHODS: The HCT-CI scores were grouped as 0 to 2 and ≥ 3 (231 and 119 patients, respectively) and the mEBMT scores as 0 to 2 and ≥ 3 (166 and 184 patients, respectively). RESULTS: Univariate analysis showed a significant association between the HCT-CI score and overall survival (OS) (P = .01), as did the mEBMT score (P = .002). The 5-year OS rate was 50% and 34% for a mEBMT score of 0 to 2 and ≥ 3, respectively. A subgroup of patients with a mEBMT score of 0 to 1 (n = 32) demonstrated a favorable OS of 75% at 5 years. This subgroup was younger (median age, 31 years), in first remission at transplantation, and had related donors. For the HCT-CI, the 5-year OS was 46% and 34% for a score of 0 to 2 and ≥ 3, respectively. Patients with an HCT-CI score of 0 (n = 94) had a 5-year OS of 44%. Multivariable analysis confirmed both the HCT-CI score and the mEBMT score, as previously grouped, as independent prognostic variables for both OS (P = .02 and P = .001, respectively) and nonrelapse mortality (NRM) (P = .01 and P = .003, respectively). CONCLUSION: The results of the present study have demonstrated that the HCT-CI and mEBMT are both prognostic for OS and NRM in our cohort. However, the mEBMT score can identify a favorable-risk subgroup of patients not identifiable using the HCT-CI.
Authors: Sagar S Patel; Lisa A Rybicki; Donna Corrigan; Brian Bolwell; Robert Dean; Hien Liu; Aaron T Gerds; Rabi Hanna; Brian Hill; Deepa Jagadeesh; Matt Kalaycio; Brad Pohlman; Ronald Sobecks; Navneet S Majhail; Betty K Hamilton Journal: Biol Blood Marrow Transplant Date: 2018-01-31 Impact factor: 5.742
Authors: F V Michelis; H A Messner; E G Atenafu; L McGillis; A Lambie; J Uhm; N Alam; M D Seftel; V Gupta; J Kuruvilla; J H Lipton; D D Kim Journal: Bone Marrow Transplant Date: 2015-07-13 Impact factor: 5.483
Authors: Lucas C Zarling; Megan Othus; Brenda M Sandmaier; Filippo Milano; Gary Schoch; Chris Davis; Marie Bleakley; H Joachim Deeg; Frederick R Appelbaum; Rainer Storb; Roland B Walter Journal: Leukemia Date: 2022-04-19 Impact factor: 12.883