Patient age, remission status and HCT-CI in a combined score are prognostic for patients with AML undergoing allogeneic hematopoietic cell transplantation in CR1 and CR2
Patient age, remission status and HCT-CI in a combined score are prognostic for patients with AML undergoing allogeneic hematopoietic cell transplantation in CR1 and CR2
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DOI：
10.1038/bmt.2015.165
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发表时间：
2015-11-01
影响因子：
4.8
通讯作者：
Kim, D. D.
中科院分区：
文献类型：
--
作者：
Michelis, F. V.;Messner, H. A.;Kim, D. D.
对于AML，年龄较大、疾病晚期和造血细胞移植合并症指数（HCT-CI）增加与异基因造血细胞移植（HCT）后的预后较差相关。这项单中心回顾性研究调查了387例接受同种异体HCT治疗CR 1和CR2 AML患者的移植前特征对结局的影响。总生存期（OS）的多变量分析模型包括年龄（31-64岁的风险比（HR）= 2.24，年龄≥ 65岁与年龄= 3与< 3相比的HR = 3.23，P = 0.005）。移植年份与OS显著相关（P = 0.001），但这并不影响模型。加权评分是在年龄= 3的情况下制定的，每种评分1分。年龄31-64岁获得2分，年龄>= 65岁获得3分。评分分组如下：0-1分（低风险，n = 36），评分2（中-低风险，n = 147），评分3（中-高风险，n = 141）和评分4-5 0-1、2、3、4-5分组3年OS分别为71%、55%、42%、29%（P < 0.0001）。该评分可预测非复发死亡率（P = 0.03），但不能预测累积复发率（P = 0.18）。应验证该模型用于CR 1和CR2 AML患者的HCT前评估。
For AML, older age, advanced disease and increased hematopoietic cell transplant comorbidity index (HCT-CI) are associated with worse prognosis following allogeneic hematopoietic cell transplantation (HCT). This single-center retrospective study investigated the influence of pre-transplant characteristics on outcomes of 387 patients undergoing allogeneic HCT for AML in CR1 and CR2. The multivariable analysis model for overall survival (OS) included age (hazard ratio (HR) = 2.24 for ages 31-64 years and HR = 3.23 for age >= 65 years compared with age = 3 compared with < 3, P = 0.005). Transplant year was significantly associated with OS (P = 0.001) but this did not influence the model. A weighted score was developed with age = 3 receiving 1 point each. Ages 31-64 received 2 points, age >= 65 received 3 points. Scores were grouped as follows: scores 0-1 (low risk, n = 36), score 2 (intermediate-low risk, n = 147), score 3 (intermediate-high risk, n = 141) and scores 4-5 (high risk, n = 63) with 3-year OS of 71%, 55%, 42% and 29% for scores 0-1, 2, 3 and 4-5, respectively (P < 0.0001). The score predicted nonrelapse mortality (P = 0.03) but not cumulative incidence of relapse (P = 0.18). This model should be validated for the pre-HCT assessment of AML patients in CR1 and CR2.