Numata Ayumi, Tanaka Masatsugu, Matsumoto Kenji, Takasaki Hirotaka, Tachibana Takayoshi, Fujimaki Katsumichi, Sakai Rika, Fujisawa Shin, Tomita Naoto, Fujita Hiroyuki, Maruta Atsuo, Ishigatsubo Yoshiaki, Kanamori Heiwa
Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan; Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan.
Clin Transplant. 2014 Apr;28(4):403-9. doi: 10.1111/ctr.12324. Epub 2014 Mar 21.
We validated the European Group for Blood and Marrow Transplantation (EBMT) risk score in 273 consecutive adult patients receiving allogeneic hematopoietic stem cell transplantation between 2000 and 2010 at our center. The patients were divided into four groups according to the EBMT risk score: low risk (LR, score 0-2), intermediate risk-1 (IR-1, score 3), intermediate risk-2 (IR-2, score 4), and high risk (HR, score 5-7). The five-yr overall survival of the LR (n = 65), IR-1 (n = 67), IR-2 (n = 70), and HR (n = 71) groups was 72%, 57%, 41%, and 25%, respectively (p < 0.001). The five-yr transplant-related mortality rates were 16%, 30%, 25%, and 36%, respectively (p = 0.07). The five-yr cumulative incidence of relapse was 20%, 18%, 37%, and 41%, respectively (p < 0.001). In the subgroup analysis, the prognostic value of the EBMT risk score was confirmed in patients undergoing myeloablative conditioning (MAC), but not in those undergoing reduced-intensity conditioning (RIC). The results suggest that the EBMT risk score is a useful tool to predict transplant outcome for patients undergoing MAC, but not for those undergoing RIC and may be beneficial for stratifying patients in clinical studies.
我们在2000年至2010年间于本中心接受异基因造血干细胞移植的273例连续成年患者中验证了欧洲血液与骨髓移植组(EBMT)风险评分。根据EBMT风险评分将患者分为四组:低风险(LR,评分0 - 2)、中风险-1(IR-1,评分3)、中风险-2(IR-2,评分4)和高风险(HR,评分5 - 7)。LR组(n = 65)、IR-1组(n = 67)、IR-2组(n = 70)和HR组(n = 71)的5年总生存率分别为72%、57%、41%和25%(p < 0.001)。5年移植相关死亡率分别为16%、30%、25%和36%(p = 0.07)。5年累积复发率分别为20%、18%、37%和41%(p < 0.001)。在亚组分析中,EBMT风险评分的预后价值在接受清髓性预处理(MAC)的患者中得到证实,但在接受减低强度预处理(RIC)的患者中未得到证实。结果表明,EBMT风险评分是预测接受MAC患者移植结局的有用工具,但对接受RIC的患者无效,可能有助于在临床研究中对患者进行分层。