Portal de investigación
Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model.
Fecha de publicación:
Fecha Ahead of Print:
Autores de IIS La Fe
Participantes ajenos a IIS La Fe
- Hernández-Boluda JC
- Pereira A
- Alvarez-Larran A
- Martín AA
- Benzaquen A
- Aguirre L
- González P
- Mora J
- Dorado N
- Sampol A
- García-Gutiérrez V
- López-Godino O
- Fox ML
- Reguera JL
- Pérez-Encinas M
- Pascual MJ
- Xicoy B
- Parody R
- González-Pinedo L
- Español I
- Avendaño A
- Correa JG
- Vallejo C
- Jurado M
- García-Cadenas I
- Osorio S
- Durán MA
- Sánchez-Guijo F
- Cervantes F
Grupos
Abstract
Accurate prognostic tools are crucial to assess the risk/benefit ratio of allogeneic hematopoietic cell transplantation (allo-HCT) in patients with myelofibrosis (MF). We aimed to evaluate the performance of the Myelofibrosis Transplant Scoring System (MTSS) and identify risk factors for survival in a multicenter series of 197 patients with MF undergoing allo-HCT. After a median follow-up of 3.1 years, 47% of patients had died, and the estimated 5-year survival rate was 51%. Projected 5-year risk of nonrelapse mortality and relapse incidence was 30% and 20%, respectively. Factors independently associated with increased mortality were a hematopoietic cell transplantation-specific comorbidity index (HCT-CI) =3 and receiving a graft from an HLA-mismatched unrelated donor or cord blood, whereas post-transplant cyclophosphamide (PT-Cy) was associated with improved survival. Donor type was the only parameter included in the MTSS model with independent prognostic value for survival. According to the MTSS, 3-year survival was 62%, 66%, 37%, and 17% for low-, intermediate-, high-, and very high-risk groups, respectively. By pooling together the low- and intermediate-risk groups, as well as the high- and very high-risk groups, we pinpointed 2 categories: standard risk and high risk (25% of the series). Three-year survival was 62% in standard-risk and 25% in high-risk categories (P < .001). We derived a risk score based on the 3 independent risk factors for survival in our series (donor type, HCT-CI, and PT-Cy). The corresponding 5-year survival for the low-, intermediate-, and high-risk categories was 79%, 55%, and 32%, respectively (P < .001). In conclusion, the MTSS model failed to clearly delineate 4 prognostic groups in our series but may still be useful to identify a subset of patients with poor outcome. We provide a simple prognostic scoring system for risk/benefit considerations before transplantation in patients with MF.
Datos de la publicación
- ISSN/ISSNe:
- 1083-8791, 1523-6536
- Tipo:
- Article
- Páginas:
- 2237-2244
- PubMed:
- 32717433
- Factor de Impacto:
- 2,301 SCImago ℠
- Cuartil:
- Q1 SCImago ℠
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION ELSEVIER SCIENCE INC
Citas Recibidas en Web of Science: 27
Documentos
- No hay documentos
Filiaciones
Keywords
- Myelofibrosis, Prognostication, Risk factors, Survival, Transplantation
Cita
Hernández JC,Pereira A,Alvarez A,Martín AA,Benzaquen A,Aguirre L,MORA E,González P,Mora J,Dorado N,Sampol A,García V,López O,Fox ML,Reguera JL,Pérez M,Pascual MJ,Xicoy B,Parody R,González L,Español I,Avendaño A,Correa JG,Vallejo C,Jurado M,García I,Osorio S,Durán MA,Sánchez F,Cervantes F,PIÑANA JL. Predicting Survival after Allogeneic Hematopoietic Cell Transplantation in Myelofibrosis: Performance of the Myelofibrosis Transplant Scoring System (MTSS) and Development of a New Prognostic Model. Biol. Blood Marrow Transplant. 2020. 26. (12):p. 2237-2244. IF:5,742. (1).