A simple prognostic system in patients with myelofibrosis undergoing allogeneic stem cell transplantation: a CIBMTR/EBMT analysis.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Tamari Roni, McLornan Donal P, Ahn Kwang Woo, Estrada-Merly Noel, Hernández-Boluda Juan Carlos, Giralt Sergio, Palmer Jeanne, Gale Robert Peter, DeFilipp Zachariah, Marks David I, van der Poel Marjolein, Verdonck Leo F, Battiwalla Minoo, Diaz Miguel Angel, Gupta Vikas, Ali Haris, Litzow Mark Robert, Lazarus Hillard M, Gergis Usama, Bashey Asad, Liesveld Jane, Hashmi Shahrukh, Pu Jeffrey J, Beitinjaneh Amer, Bredeson Christopher, Rizzieri David, Savani Bipin N, Abid Muhammad Bilal, Ganguly Siddhartha, Agrawal Vaibhav, Ulrike Bacher Vera, Wirk Baldeep, Jain Tania, Cutler Corey, Aljurf Mahmoud, Kindwall-Keller Tamila, Kharfan-Dabaja Mohamed A, Hildebrandt Gerhard C, Pawarode Attaphol, Solh Melhem M, Yared Jean A, Grunwald Michael R, Nathan Sunita, Nishihori Taiga, Seo Sachiko, Scott Bart L, Nakamura Ryotaro, Oran Betul, Czerw Tomasz, Yakoub-Agha Ibrahim, Saber Wael
Аннотация
To develop a prognostic model for patients undergoing allogeneic hematopoietic cell transplantation (allo-HCT) for myelofibrosis (MF), we examined the data of 623 patients undergoing allo-HCT between 2000 and 2016 in the United States (the Center for International Blood and Marrow Transplant Research [CIBMTR] cohort). A Cox multivariable model was used to identify factors prognostic of mortality. A weighted score using these factors was assigned to patients who received transplantation in Europe (the European Bone Marrow Transplant [EBMT] cohort; n = 623). Patient age >50 years (hazard ratio [HR], 1.39; 95% confidence interval [CI], 0.98-1.96), and HLA-matched unrelated donor (HR, 1.29; 95% CI, 0.98-1.7) were associated with an increased hazard of death and were assigned 1 point. Hemoglobin levels <100 g/L at time of transplantation (HR, 1.63; 95% CI, 1.2-2.19) and a mismatched unrelated donor (HR, 1.78; 95% CI, 1.25-2.52) were assigned 2 points. The 3-year overall survival (OS) in patients with a low (1-2 points), intermediate (3-4 points), and high score (5 points) were 69% (95% CI, 61-76), 51% (95% CI, 46-56.4), and 34% (95% CI, 21-49), respectively (P < .001). Increasing score was predictive of increased transplant-related mortality (TRM; P = .0017) but not of relapse (P = .12). The derived score was predictive of OS (P < .001) and TRM (P = .002) but not of relapse (P = .17) in the EBMT cohort as well. The proposed system was prognostic of survival in 2 large cohorts, CIBMTR and EBMT, and can easily be applied by clinicians consulting patients with MF about the transplantation outcomes.