Department of Hematology, Oncology and Tumorimmunology, Charité- Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Eur J Haematol. 2011 Apr;86(4):305-16. doi: 10.1111/j.1600-0609.2011.01580.x.
The systematic and standardized pretransplant risk assessment represents an important tool to predict the outcome of patients undergoing allogeneic stem cell transplantation (alloSCT). To investigate the capacity of a modified European group for blood and marrow transplantation (mEBMT) risk score to predict the outcome of patients with acute myeloid leukemia (AML) receiving allogeneic stem cell transplants, we retrospectively analyzed 214 patients transplanted at our center between 1995 and 2008. Overall survival (OS) of the whole cohort at 1, 3, and 5 yr was 62%, 48%, and 45%, whereas the cumulative incidence of relapse or non-relapse mortality (NRM) was 26%, 33%, and 33% or 19%, 21%, and 22%. In univariate analysis, a higher mEBMT risk score was associated with an inferior OS ranging from 69% for patients with a score of 0/1 to 26% for patients with a score of 5/6 at 5 yr (P < 0.0001) and steadily increasing hazard ratios for each additional score point. Likewise, a higher mEBMT risk score was associated with an increased incidence of relapse (P = 0.049). Importantly, the prognostic value of the mEBMT risk score in terms of OS and relapse was maintained in multivariate analysis. Taken together, this indicates that a mEBMT risk score may be used to predict the outcome of patients with AML following alloSCT.
移植前的系统和标准化风险评估代表了预测接受异基因造血干细胞移植（alloSCT）患者结局的重要工具。为了研究改良欧洲血液和骨髓移植组（mEBMT）风险评分预测接受异基因造血干细胞移植的急性髓系白血病（AML）患者结局的能力，我们回顾性分析了 1995 年至 2008 年在我们中心接受移植的 214 例患者。整个队列的总生存率（OS）在 1、3 和 5 年时分别为 62%、48%和 45%，而复发或非复发死亡率（NRM）的累积发生率分别为 26%、33%和 33%或 19%、21%和 22%。在单因素分析中，较高的 mEBMT 风险评分与 OS 不良相关，风险评分范围从 0/1 分的患者 5 年时的 69%到 5/6 分的患者的 26%（P<0.0001），且每个额外评分点的危险比均稳步增加。同样，较高的 mEBMT 风险评分与复发发生率增加相关（P=0.049）。重要的是，mEBMT 风险评分在 OS 和复发方面的预后价值在多因素分析中得到了保持。总之，这表明 mEBMT 风险评分可用于预测接受 alloSCT 的 AML 患者的结局。
