Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.
Peking University People's Hospital, Peking University Institute of Hematology, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China; Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China.
Biol Blood Marrow Transplant. 2017 Dec;23(12):2143-2150. doi: 10.1016/j.bbmt.2017.08.026. Epub 2017 Sep 1.
This study aimed to validate the capability of the Center for International Blood and Marrow Transplant Research (CIBMTR) prognostic scoring system to predict outcomes of patients with myelodysplastic syndromes (MDS) who had undergone HLA-haploidentical related donor hematopoietic stem cell transplantation (haplo-HSCT). We also propose and validate a more suitable prognostic scoring system. A total of 157 patients with MDS who underwent haplo-HSCT were enrolled. The CIBMTR prognostic scoring system could predict the 2-year clinical outcomes, but failed to predict the 100-day clinical outcomes after haplo-HSCT. Our multivariable model identified 2 independent predictors of overall survival: age and monosomal karyotype (MK). Weighted scores of 5, 3, and 2 were assigned to age ≥50 years, age 30 to 49 years, and MK, respectively, and a 2-category system was created: low (score ≤3) and high (score >3). Our refined prognostic scoring system can predict both the 100-day and 2-year clinical outcomes after haplo-HSCT. Our findings indicate that the CIBMTR prognostic scoring system is predictive of the outcomes of patients with MDS following haplo-HSCT, and that older patients with MDS and/or patients with MK should be closely monitored after haplo-HSCT.
本研究旨在验证国际血液和骨髓移植研究中心（CIBMTR）预后评分系统预测接受 HLA 单倍体相关供者造血干细胞移植（haplo-HSCT）的骨髓增生异常综合征（MDS）患者结局的能力。我们还提出并验证了一个更合适的预后评分系统。共纳入 157 例接受 haplo-HSCT 的 MDS 患者。CIBMTR 预后评分系统可预测 2 年临床结局，但不能预测 haplo-HSCT 后 100 天的临床结局。我们的多变量模型确定了总生存的 2 个独立预测因素：年龄和单倍体核型（MK）。年龄≥50 岁、年龄 30 至 49 岁和 MK 分别赋予加权分数 5、3 和 2，并创建了 2 个类别系统：低（评分≤3）和高（评分>3）。我们的改良预后评分系统可预测 haplo-HSCT 后 100 天和 2 年的临床结局。我们的研究结果表明，CIBMTR 预后评分系统可预测 MDS 患者接受 haplo-HSCT 后的结局，年龄较大的 MDS 患者和/或具有 MK 的患者应在 haplo-HSCT 后密切监测。
