Alexis Caulier1, Elodie Drumez2, Jordan Gauthier3, Marie Robin4, Didier Blaise5, Yves Beguin6, Mauricette Michallet7, Patrice Chevallier8, Jacques-Olivier Bay9, Stéphane Vigouroux10, Yohan Desbrosses11, Jérôme Cornillon12, Stéphanie Nguyen13, Charles Dauriac14, Régis Peffault de Latour4, Bruno Lioure15, Pierre-Simon Rohrlich16, Martin Carré17, Jean-Henri Bourhis18, Anne Huynh19, Felipe Suarez20, Federico Garnier21, Alain Duhamel2, Ibrahim Yakoub-Agha22. 1. Hématologie, Centre Hospitalier Universitaire (CHU) Sud, Amiens, France. 2. Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de biostatistique, F-59000 Lille, France. 3. CHU de Lille, LIRIC, INSERM U995, Université de Lille, 59000 Lille, France. 4. Hématologie-Transplantation, AP-HP, Hôpital Saint Louis, Université Paris 7, Paris, France. 5. Hématologie, Institut Paoli-Calmettes, Marseille, France. 6. Hématologie, University of Liège, Belgium. 7. Hématologie, CHU Lyon Sud, Lyon, France. 8. Hématologie, CHU, Nantes, France. 9. Hématologie, CHU, Clermont Ferrand, France. 10. Hématologie, CHU, Bordeaux, France. 11. Hématologie, CHU, Besançon, France. 12. Hématologie, Institut de Cancérologie de la Loire, Saint-Etienne, France. 13. Hématologie, Hôpital de la Pitié-Salpêtrière, Université Paris 6, Paris, France. 14. Hématologie, CHU, Rennes, France. 15. Hématologie, CHU, Strasbourg, France. 16. Hématologie, CHU, Nice, France. 17. Hématologie, CHU, Grenoble, France. 18. Institut Gustave Roussy, Villejuif, France. 19. Hématologie, CHU Purpan, Toulouse, France. 20. Hématologie adulte, AP-HP, Hôpital Necker, Université Paris 5, Paris, France. 21. Agence de la biomédecine, Saint Denis, France. 22. CHU de Lille, LIRIC, INSERM U995, Université de Lille, 59000 Lille, France. Electronic address: ibrahim.yakoubagha@chru-lille.fr.
Abstract
PURPOSE: We developed a prognostic scoring system to evaluate the prognosis of myelodysplastic syndrome (MDS) patients surviving more than 100 days allogeneic hematopoietic cell transplantation after (allo-HCT). PATIENTS AND METHODS: We performed a landmark analysis on a derivation cohort of 393 cases to identify prognostic factors for 3-year overall survival. Potential predictor variables included demographic and clinical data, transplantation modalities and early post-transplant complications. The scoring system was tested against a validation cohort which included 391 patients. RESULTS: Complications occurring before day 100 such as relapse [HR = 6.7; 95%CI, 4.5-10.0] (4 points), lack of platelet recovery [HR, 3.6; 95%CI, 2.2-5.8] (2 points), grade-II acute GVHD [HR = 1.7; 95%CI, 1.2-2.5] (1 point) and grade-III/IV [HR = 2.6; 95%CI, 1.8 -3.8] (2 points) were the only independent predictors of 3-year OS. The 3-year OS associated with low (0), intermediate (1-3) and high (≥4) risk scores was respectively 70%, 46% and 6%. The model performed consistently in both cohorts, with good calibration. CONCLUSION: This post-transplant scoring system is a powerful predictor of outcome after allo-HCT for MDS, and can provide useful guidance for clinicians. Additional studies are required to evaluate this scoring system for other hematologic malignancies.
RCT Entities:
PURPOSE: We developed a prognostic scoring system to evaluate the prognosis of myelodysplastic syndrome (MDS) patients surviving more than 100 days allogeneic hematopoietic cell transplantation after (allo-HCT). PATIENTS AND METHODS: We performed a landmark analysis on a derivation cohort of 393 cases to identify prognostic factors for 3-year overall survival. Potential predictor variables included demographic and clinical data, transplantation modalities and early post-transplant complications. The scoring system was tested against a validation cohort which included 391 patients. RESULTS: Complications occurring before day 100 such as relapse [HR = 6.7; 95%CI, 4.5-10.0] (4 points), lack of platelet recovery [HR, 3.6; 95%CI, 2.2-5.8] (2 points), grade-II acute GVHD [HR = 1.7; 95%CI, 1.2-2.5] (1 point) and grade-III/IV [HR = 2.6; 95%CI, 1.8 -3.8] (2 points) were the only independent predictors of 3-year OS. The 3-year OS associated with low (0), intermediate (1-3) and high (≥4) risk scores was respectively 70%, 46% and 6%. The model performed consistently in both cohorts, with good calibration. CONCLUSION: This post-transplant scoring system is a powerful predictor of outcome after allo-HCT for MDS, and can provide useful guidance for clinicians. Additional studies are required to evaluate this scoring system for other hematologic malignancies.
Authors: Juan Carlos Hernández-Boluda; Arturo Pereira; Nicolaus Kröger; Dietrich Beelen; Marie Robin; Martin Bornhäuser; Emanuele Angelucci; Antonin Vitek; Igor Wolfgang Blau; Riitta Niittyvuopio; Jürgen Finke; Jan J Cornelissen; Jakob Passweg; Peter Dreger; Eefke Petersen; Lothar Kanz; Jaime Sanz; Tsila Zuckerman; Nienke Zinger; Simona Iacobelli; Patrick Hayden; Tomasz Czerw; Donal McLornan; Ibrahim Yakoub-Agha Journal: Leukemia Date: 2020-04-14 Impact factor: 11.528