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Caulier A, Drumez E, Gauthier J, Robin M, Blaise D, Beguin Y, Michallet M, Chevallier P, Bay JO, Vigouroux S, Desbrosses Y, Cornillon J, Nguyen S, Dauriac C, de Latour RP, Lioure B, Rohrlich PS, Carré M, Bourhis JH, Huynh A, Suarez F, Garnier F, Duhamel A, Yakoub-Agha I. Scoring System Based on Post-Transplant Complications in Patients after Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndrome: A Study from the SFGM-TC. Curr Res Transl Med 2018; 67:8-15. [PMID: 30206045 DOI: 10.1016/j.retram.2018.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Accepted: 08/20/2018] [Indexed: 12/31/2022]
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.
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Affiliation(s)
- Alexis Caulier
- Hématologie, Centre Hospitalier Universitaire (CHU) Sud, Amiens, France
| | - Elodie Drumez
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de biostatistique, F-59000 Lille, France
| | - Jordan Gauthier
- CHU de Lille, LIRIC, INSERM U995, Université de Lille, 59000 Lille, France
| | - Marie Robin
- Hématologie-Transplantation, AP-HP, Hôpital Saint Louis, Université Paris 7, Paris, France
| | - Didier Blaise
- Hématologie, Institut Paoli-Calmettes, Marseille, France
| | | | | | | | | | | | | | - Jérôme Cornillon
- Hématologie, Institut de Cancérologie de la Loire, Saint-Etienne, France
| | - Stéphanie Nguyen
- Hématologie, Hôpital de la Pitié-Salpêtrière, Université Paris 6, Paris, France
| | | | | | | | | | | | | | - Anne Huynh
- Hématologie, CHU Purpan, Toulouse, France
| | - Felipe Suarez
- Hématologie adulte, AP-HP, Hôpital Necker, Université Paris 5, Paris, France
| | | | - Alain Duhamel
- Univ. Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, Unité de biostatistique, F-59000 Lille, France
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