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- Title
Comparison of the Prognostic Ability of the HCT-CI, the Modified EBMT, and the EBMT-ADT Pre-transplant Risk Scores for Acute Leukemia.
- Authors
Al-Shaibani, Eshrak; Cyriac, Sunu; Chen, Shiyi; Lipton, Jeffrey H.; Kim, Dennis D.; Viswabandya, Auro; Kumar, Rajat; Lam, Wilson; Law, Arjun; Al-Shaibani, Zeyad; Gerbitz, Armin; Pasic, Ivan; Mattsson, Jonas; Michelis, Fotios V.
- Abstract
<bold>Background: </bold>Allogeneic hematopoietic cell transplantation (HCT) outcomes may be predicted by published risk scores; however, the ideal system has not been identified for acute leukemias.<bold>Patients and Methods: </bold>We retrospectively examined the Hematopoietic Cell Transplantation-Comorbidity Index (HCT-CI), modified European Group for Blood and Marrow Transplantation (mEBMT), EBMT-Alternating Decision Tree (ADT), and others on 231 patients with acute leukemia.<bold>Results: </bold>Acute myeloid leukemia was diagnosed in 200 patients, and acute lymphocytic leukemia was diagnosed in 31 patients. For HCT-CI, patients were grouped as 0 to 1, 2 to 3, and > 3. For mEBMT, patients were grouped as 0 to 2, 3, and > 3. For EBMT-ADT, the 100-day mortality was calculated and grouped as ≤ 4.1%, 4.1% to 11.5%, and > 11.5%. Higher HCI-CI demonstrated inferior overall survival (P = .04; c-statistic, 0.57), whereas mEBMT and EBMT-ADT did not stratify well. A new weighted score was developed that assigned 1 point for age ≥ 60 years, acute lymphocytic leukemia diagnosis, mismatch unrelated or haploidentical donor, cardiovascular comorbidity, and pre-transplant diabetes, whereas arrhythmia received 2 points. The new weighted score assigned 0 points to 88 (38%), 1 to 2 points to 121 (52%) and ≥ 3 points to 22 (10%) patients, and demonstrated improved prognostic capability compared with the other scores (P = .0001; c-statistic, 0.61).<bold>Conclusions: </bold>The HCT-CI stratifies patients with leukemia for overall survival but is inferior to our single-center score, which is influenced by cardiac comorbidity and arrhythmia. Differences in pre-transplant risk scores may be related to different transplant practices.
- Publication
Clinical Lymphoma, Myeloma & Leukemia, 2021, Vol 21, Issue 6, pe559
- ISSN
2152-2650
- Publication type
journal article
- DOI
10.1016/j.clml.2021.01.022