Prediction of non-relapse mortality in recipients of reduced intensity conditioning allogeneic stem cell transplantation with AML in first complete remission

J. Versluis, M. Labopin, D. Niederwieser, G. Socie, R. F. Schlenk, N. Milpied, A. Nagler, D. Blaise, V. Rocha, J. J. Cornelissen*, M. Mohty

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Non-relapse mortality (NRM) after allogeneic hematopoietic stem cell transplantation (alloHSCT) can be predicted by the hematopoietic cell transplantation comorbidity index (HCT-CI) and the European Group for Blood and Marrow Transplantation (EBMT) score, which are composed of different parameters. We set out to integrate the parameters of both scores in patients with acute myeloid leukemia (AML) in first complete remission (CR1) receiving reduced intensity conditioning (RIC) alloHSCT. All parameters from the HCT-CI and the EBMT-score with the addition of patient and donor cytomegalovirus serology were evaluated in 812 patients by multivariable analysis with end-point NRM at 2 years. Subsequently, 16 parameters were selected based on hazard ratio >1.2, and were incorporated into a novel score, which was further internally validated by bootstrapping. Both the HCT-CI and the EBMT-score showed relatively weak predictive value, whereas the integrated score allowed to identify three clearly distinct risk groups with 2-year NRM estimates of 8±2% (low-risk), 17±2% (intermediate-risk) and 38±4% (high-risk), which also translated in prediction of overall survival. Collectively, integration of the most dominant parameters from the HCT-CI and the EBMT-score allowed to develop a simple and robust, integrated score with improved prediction of NRM for AML patients proceeding to RIC alloHSCT in CR1.

Original languageEnglish
Pages (from-to)51-57
Number of pages7
JournalLeukemia
Volume29
Issue number1
DOIs
StatePublished - 10 Jan 2015
Externally publishedYes

Funding

FundersFunder number
Erasmus University Medical Center Cancer Institute
Institute of Infection and Immunity
Institut national de la santé et de la recherche médicale
Association Nationale de la Recherche et de la Technologie
Chung Hua University

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