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Allografting

Validation of pretransplantation assessment of mortality risk score in the outcome of hematopoietic SCT in non-Caucasians

Abstract

The Pretransplantation Assessment of Mortality (PAM) score is a risk score for mortality after allogeneic hematopoietic SCT (HSCT). Ethnicity is a genetically determined factor that correlated with immune-mediated outcomes of allogeneic HSCT. We evaluated the predictive value of the PAM score for transplant outcome in 276 Japanese populations in which transplant-related complications occur less frequently than Caucasians. The PAM score effectively risk-stratified these patients for survival; overall survival (OS) at 2 years was 100%, 80.2%, 49.4%, and 13.9% in the categories 1, 2, 3, and 4, respectively, showing a clear distinction of OS by categories (P<0.001). In addition, the PAM score is useful for the prediction of transplant outcomes both in patients with standard-risk underlying diseases and those with high-risk diseases. The PAM score developed in Caucasian populations is thus useful in non-Caucasian populations.

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References

  1. Parimon T, Au DH, Martin PJ, Chien JW . A risk score for mortality after allogeneic hematopoietic cell transplantation. Ann Intern Med 2006; 144: 407–414.

    Article  PubMed  Google Scholar 

  2. Barba P, Pinana JL, Martino R, Valcarcel D, Amoros A, Sureda A et al. Comparison of two pretransplant predictive models and a flexible HCT-CI using different cut off points to determine low-, intermediate-, and high-risk groups: the flexible HCT-CI Is the best predictor of NRM and OS in a population of patients undergoing allo-RIC. Biol Blood Marrow Transplant 2010; 16: 413–420.

    Article  PubMed  Google Scholar 

  3. Xhaard A, Porcher R, Chien JW, de Latour RP, Robin M, Ribaud P et al. Impact of comorbidity indexes on non-relapse mortality. Leukemia 2008; 22: 2062–2069.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Morishima Y, Kodera Y, Hirabayashi N, Tanimoto M, Matsuyama T, Horibe K et al. Low incidence of acute GVHD in patients transplanted with marrow from HLA-A,B,DR-compatible unrelated donors among Japanese. Bone Marrow Transplant 1995; 15: 235–239.

    CAS  PubMed  Google Scholar 

  5. Lin MT, Storer B, Martin PJ, Tseng LH, Gooley T, Chen PJ et al. Relation of an interleukin-10 promoter polymorphism to graft-versus-host disease and survival after hematopoietic-cell transplantation. N Engl J Med 2003; 349: 2201–2210.

    Article  CAS  PubMed  Google Scholar 

  6. Oh H, Loberiza Jr FR, Zhang MJ, Ringden O, Akiyama H, Asai T et al. Comparison of graft-versus-host-disease and survival after HLA-identical sibling bone marrow transplantation in ethnic populations. Blood 2005; 105: 1408–1416.

    Article  CAS  PubMed  Google Scholar 

  7. Gratwohl A, Hermans J, Goldman JM, Arcese W, Carreras E, Devergie A et al. Risk assessment for patients with chronic myeloid leukaemia before allogeneic blood or marrow transplantation. Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation. Lancet 1998; 352: 1087–1092.

    Article  CAS  PubMed  Google Scholar 

  8. Gratwohl A, Stern M, Brand R, Apperley J, Baldomero H, de Witte T et al. Risk score for outcome after allogeneic hematopoietic stem cell transplantation: a retrospective analysis. Cancer 2009; 115: 4715–4726.

    Article  PubMed  Google Scholar 

  9. Tsukasaki K, Hermine O, Bazarbachi A, Ratner L, Ramos JC, Harrington Jr W et al. Definition, prognostic factors, treatment, and response criteria of adult T-cell leukemia-lymphoma: a proposal from an international consensus meeting. J Clin Oncol 2009; 27: 453–459.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood 2005; 106: 2912–2919.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Charlson ME, Pompei P, Ales KL, MacKenzie CR . A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chron Dis 1987; 40: 373–383.

    Article  CAS  PubMed  Google Scholar 

  12. Sorror ML, Sandmaier BM, Storer BE, Maris MB, Baron F, Maloney DG et al. Comorbidity and disease status based risk stratification of outcomes among patients with acute myeloid leukemia or myelodysplasia receiving allogeneic hematopoietic cell transplantation. J Clin Oncol 2007; 25: 4246–4254.

    Article  PubMed  Google Scholar 

  13. Farina L, Bruno B, Patriarca F, Spina F, Sorasio R, Morelli M et al. The hematopoietic cell transplantation comorbidity index (HCT-CI) predicts clinical outcomes in lymphoma and myeloma patients after reduced-intensity or non-myeloablative allogeneic stem cell transplantation. Leukemia 2009; 23: 1131–1138.

    Article  CAS  PubMed  Google Scholar 

  14. Majhail NS, Brunstein CG, McAvoy S, DeFor TE, Al-Hazzouri A, Setubal D et al. Does the hematopoietic cell transplantation specific comorbidity index predict transplant outcomes? A validation study in a large cohort of umbilical cord blood and matched related donor transplants. Biol Blood Marrow Transplant 2008; 14: 985–992.

    Article  CAS  PubMed  Google Scholar 

  15. Terwey TH, Hemmati PG, Martus P, Dietz E, Vuong LG, Massenkeil G et al. A modified EBMT risk score and the hematopoietic cell transplantation-specific comorbidity index for pre-transplant risk assessment in adult acute lymphoblastic leukemia. Haematologica 2010; 95: 810–818.

    Article  PubMed  Google Scholar 

  16. Hemmati PG, Terwey TH, le Coutre P, Vuong LG, Massenkeil G, Dorken B et al. A modified EBMT risk score predicts the outcome of patients with acute myeloid leukemia receiving allogeneic stem cell transplants. Eur J Haematol 2011; 86: 305–316.

    Article  PubMed  Google Scholar 

  17. Gooley TA, Chien JW, Pergam SA, Hingorani S, Sorror ML, Boeckh M et al. Reduced mortality after allogeneic hematopoietic-cell transplantation. N Engl J Med 2010; 363: 2091–2101.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Chien JW, Sullivan KM . Carbon monoxide diffusion capacity: how low can you go for hematopoietic cell transplantation eligibility? Biol Blood Marrow Transplant 2009; 15: 447–453.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Hishizawa M, Kanda J, Utsunomiya A, Taniguchi S, Eto T, Moriuchi Y et al. Transplantation of allogeneic hematopoietic stem cells for adult T-cell leukemia: a nationwide retrospective study. Blood 2010; 116: 1369–1376.

    Article  CAS  PubMed  Google Scholar 

  20. Gratwohl A, Baldomero H, Aljurf M, Pasquini MC, Bouzas LF, Yoshimi A et al. Hematopoietic stem cell transplantation: a global perspective. JAMA 2010; 303: 1617–1624.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Acknowledgements

This work was supported in part by a Grant-in-Aid from the Ministry of Education, Culture, Sports and Science and Technology in Japan to TT.

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Correspondence to T Teshima.

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Mori, Y., Teshima, T., Kamezaki, K. et al. Validation of pretransplantation assessment of mortality risk score in the outcome of hematopoietic SCT in non-Caucasians. Bone Marrow Transplant 47, 1075–1081 (2012). https://doi.org/10.1038/bmt.2011.229

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