Validation of the acute leukemia-EBMT score for prediction of mortality following allogeneic stem cell transplantation in a multi-center GITMO cohort
Roni Shouval,Francesca Bonifazi,Joshua A Fein,Cristina Boschini,Elena Oldani,Myriam Labopin,Roberto Raimondi,Nicoletta Sacchi,Osamah Dabash,Ron Unger,Mohamad Mohty,Alessandro Rambaldi,Arnon Nagler +12 more
TLDR
The first external validation of the AL‐EBMT score in a cohort of AL patients from the Italian national transplantation network is reported, finding it is a valid tool for stratifying the risk of acute leukemia patients undergoing allogeneic HSCT.Abstract:
Predictive models may help in determining the risk/benefit ratio of allogeneic hematopoietic stem cell transplantation (HSCT) in acute leukemia (AL). Using a machine-learning algorithm we have previously developed the AL- European Society for Blood and Marrow Transplantation (EBMT) score for prediction of mortality following transplantation. We report here the first external validation of the AL-EBMT score in a cohort of AL patients from the Italian national transplantation network. A total of 1848 patients transplanted between the years 2000-2014 were analyzed. The median age was 45.9. Indications for HSCT were Acute Myeloid Leukemia (68.1%) and Acute Lymphoblastic Leukemia (31.9%). The majority of patients were in first complete remission (60.4%), and received myeloablative conditioning (81.3%). Median follow-up was 2 years. The score was well-calibrated for prediction of day 100 mortality and 2-year overall survival (OS), leukemia free survival (LFS), and nonrelapse related mortality, with corresponding area under the receiver-operator curves of 0.698, 0.651, 0.653, and 0.651, respectively. Increasing score intervals were associated with a decreasing probability of 2-year OS and LFS. The highest scoring group was associated with a hazard ratio of 3.16, 2.8, and 2.27 for 2-year OS, LFS, and NRM, respectively. In conclusion, the AL-EBMT score identified three distinct risk groups and was predictive of OS. It is a valid tool for stratifying the risk of acute leukemia patients undergoing allogeneic HSCT.read more
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Hematopoietic Cell Transplantation in the Treatment of Newly Diagnosed Adult Acute Myeloid Leukemia: An Evidence-Based Review from the American Society of Transplantation and Cellular Therapy.
Bhagirathbhai Dholaria,Bipin N. Savani,Betty K. Hamilton,Betul Oran,Hien D. Liu,Martin S. Tallman,Stefan O. Ciurea,Noa G. Holtzman,Gordon L. Phillips,Steven M. Devine,Gabriel N. Mannis,Michael R. Grunwald,Frederick R. Appelbaum,Cesar Rodriguez,Firas El Chaer,Nina Shah,Shahrukh K. Hashmi,Mohamed A. Kharfan-Dabaja,Zachariah DeFilipp,Mahmoud Aljurf,Al Fadel AlShaibani,Yoshihiro Inamoto,Tania Jain,Navneet S. Majhail,Miguel-Angel Perales,Miguel-Angel Perales,Mohamad Mohty,Mehdi Hamadani,Paul A. Carpenter,Arnon Nagler +29 more
TL;DR: The role of hematopoietic cell transplantation in the management of newly diagnosed adult acute myeloid leukemia (AML) is reviewed and critically evaluated and the preferential use of myeloablative conditioning in eligible patients is recommended.
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Prognostic Scoring Systems in Allogeneic Hematopoietic Stem Cell Transplantation: Where Do We Stand?
Rashmika Potdar,Gabor Varadi,Joshua A Fein,Joshua A Fein,Myriam Labopin,Arnon Nagler,Arnon Nagler,Roni Shouval,Roni Shouval +8 more
TL;DR: The clinical role of the prognostic systems currently in clinical use are reviewed, examining both their strengths and their limitations.
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