Shibasaki Yasuhiko, Suwabe Tatsuya, Katagiri Takayuki, Tanaka Tomoyuki, Kobayashi Hironori, Fuse Kyoko, Ushiki Takashi, Sato Naoko, Yano Toshio, Kuroha Takashi, Hashimoto Shigeo, Narita Miwako, Furukawa Tatsuo, Sone Hirohito, Masuko Masayoshi
Department of Hematopoietic Cell Transplantation, Niigata University Medical and Dental Hospital, Niigata City, Japan.
Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata City, Japan.
Clin Transplant. 2017 Nov;31(11). doi: 10.1111/ctr.13103. Epub 2017 Oct 22.
Evaluation methods, such as scoring systems for predicting complications in advance, are necessary for determining the adaptation of allogeneic hematopoietic cell transplantation (HCT) and selecting appropriate conditioning regimens. The Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI), which is based on functions of main organs, is a useful tool for pre-transplant risk assessments and has been widely applied in determining treatment strategies for patients with hematological diseases. However, as allogeneic HCT is performed on patients with diverse backgrounds, another factor, which reinforces the HCT-CI, is required to evaluate pre-transplant risk assessments. The Glasgow Prognostic Score (GPS), which assesses the combined C-reactive protein and albumin, was reported to predict survival of patients with solid-organ malignancies independently of receiving chemo/radiotherapy and stages of cancer. In this study, we applied the GPS for pre-transplant risk assessments for allogeneic HCT. The GPS successfully stratified the patients into three risk groups of overall survival (OS) and non-relapse mortality (NRM). Moreover, the GPS could predict outcomes independently of the HCT-CI for OS and NRM in multivariate analysis. The GPS is considered to be a useful tool and reinforces the HCT-CI for determining adaptation of allogeneic HCT for patients with hematopoietic neoplasms.
评估方法,如用于提前预测并发症的评分系统,对于确定异基因造血细胞移植(HCT)的适应性和选择合适的预处理方案是必要的。基于主要器官功能的造血细胞移植特异性合并症指数(HCT-CI)是移植前风险评估的有用工具,已广泛应用于确定血液系统疾病患者的治疗策略。然而,由于异基因HCT是在背景各异的患者中进行的,因此需要另一个强化HCT-CI的因素来评估移植前风险评估。据报道,评估C反应蛋白和白蛋白综合水平的格拉斯哥预后评分(GPS)可独立于接受化疗/放疗及癌症分期预测实体器官恶性肿瘤患者的生存情况。在本研究中,我们将GPS应用于异基因HCT的移植前风险评估。GPS成功地将患者分为总生存(OS)和非复发死亡率(NRM)的三个风险组。此外,在多变量分析中,GPS可独立于HCT-CI预测OS和NRM的结果。GPS被认为是一种有用的工具,可强化HCT-CI以确定异基因HCT对造血系统肿瘤患者的适应性。