Department of Hematology, Kanagawa Cancer Center, Yokohama, Japan.
Am J Hematol. 2014 Sep;89(9):E138-41. doi: 10.1002/ajh.23764. Epub 2014 Jun 20.
Reduced-intensity conditioning allogeneic stem cell transplantation (RIC allo-SCT) is associated with less toxicity and is used for older patients. We retrospectively studied the predictive value of two risk assessment scores, which were the hematopoietic cell transplantation-specific comorbidity index (HCT-CI) and the pre-transplantation assessment of mortality (PAM) score, for assessing the outcome of RIC allo-SCT. Seventy-eight patients underwent transplantation between 2005 and 2013 at a single institution. RIC was performed with fludarabine and melphalan with/without total body irradiation. The 3-year overall survival of patients with an HCT-CI >3 was significantly worse than that of patients with an HCT-CI 0-3 (31.6% vs. 59.6%, P = 0.020). Also, the 3-year overall survival of patients with a PAM score >24 was significantly worse than that of those with a PAM score ≤24 (29.2% vs. 61.4%, P = 0.005). The present findings suggest that changing the cut-off values of these risk assessment scores can improve prediction of outcomes in patients receiving RIC allo-SCT with this conditioning regimen and we need validation by large-scale study with other regimens.
降低强度预处理的异基因造血干细胞移植(RIC allo-SCT)相关毒性较低,用于老年患者。我们回顾性研究了两种风险评估评分的预测价值,即造血细胞移植特异性合并症指数(HCT-CI)和移植前死亡率评估(PAM)评分,用于评估 RIC allo-SCT 的结果。78 例患者于 2005 年至 2013 年在单中心接受移植。RIC 采用氟达拉滨和马法兰,联合/不联合全身照射。HCT-CI >3 的患者 3 年总生存率明显低于 HCT-CI 0-3 的患者(31.6%比 59.6%,P=0.020)。此外,PAM 评分>24 的患者 3 年总生存率明显低于 PAM 评分≤24 的患者(29.2%比 61.4%,P=0.005)。这些发现表明,改变这些风险评估评分的截止值可以改善该预处理方案的 RIC allo-SCT 患者的预后预测,我们需要用其他方案进行大规模研究验证。