European Group for Blood and Marrow Transplantation Risk Score Predicts the Outcome of Patients with Acute Leukemia Receiving Single Umbilical Cord Blood Transplantation

被引：10

作者：

Zhu, Xiaoyu ^{[1
]}

Huang, Lulu ^{[1
]}

Zheng, Changcheng ^{[1
]}

Tang, Baolin ^{[1
]}

Liu, Huilan ^{[1
]}

Geng, Liangquan ^{[1
]}

Tong, Juan ^{[1
]}

Zhang, Lei ^{[1
]}

Zhang, Xuhan ^{[1
]}

Yao, Wen ^{[1
]}

Song, Kaidi ^{[1
]}

Wang, Xingbing ^{[1
]}

Ding, Kaiyang ^{[1
]}

Sun, Zimin ^{[1
]}

机构：

[1] Anhui Med Univ, Anhui Prov Hosp, Dept Hematol, Hefei 230001, Anhui, Peoples R China

来源：

BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION | 2017年 / 23卷 / 12期

基金：

中国国家自然科学基金;

关键词：

Single umbilical cord blood transplantation; Patients with acute leukemia; EBMT risk score; Outcome prediction; HEMATOPOIETIC-CELL TRANSPLANTATION; CHRONIC MYELOID-LEUKEMIA; COMORBIDITY INDEX; ADULT PATIENTS; IMPACT; DISEASE; COMBINATION; CHILDREN;

D O I：

10.1016/j.bbmt.2017.08.011

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The European Group for Blood and Marrow Transplantation (EBMT) risk score has been implemented as an important tool to predict patient outcomes after allogeneic hematopoietic stem cell transplantation. However, to our knowledge, this score has never been applied in cases of single umbilical cord blood transplantation (sUCBT). We retrospectively analyzed 207 consecutive patients with acute leukemia who received sUCBT at our center between February 2011 and December 2015. The probabilities of 3-year overall survival (OS) and leukemia-free survival (LFS) of the entire cohort were 65.0% and 59.8%, respectively, whereas the cumulative incidences of 3-year nonrelapse mortality (NRM) and relapse rate were 19.5% and 20.3%, respectively. In the univariate analysis, a higher EBMT risk score was associated with worse OS and LFS and higher NRM and relapse rate, ranging from 81.7%, 75.9%, 7.3%, and 15.3%, respectively, for patients with a score of 1 to 43.8%, 44.3%, 31.7%, and 23.9%, respectively, for patients with scores of 4 to 6. Hazard ratios of OS, LFS, and NRM all steadily increased for each additional score point. Importantly, the prognostic value of the EBMT risk score on OS, LFS, NRM, and relapse was maintained in the multivariate analysis. Moreover, considering the univariate analysis results of donor-recipient gender and mismatched allele-level HLA-A, -B, -C, and -DRB1 loci on patient outcomes and the fairly strong interaction between time from diagnosis to sUCBT and disease status, we developed a modified sUCBT-EBMT risk score by using degrees of 8-allele HLA match instead of donor type, donor recipient gender combination, and time from diagnosis to sUCBT, and found that the modified score could also be used as a predictor for patient outcomes after sUCBT. The EBMT risk score is a good predictor of outcomes of patients with leukemia after sUCBT. The modified sUCBT-EBMT risk score can also be used as a pretranspiant risk assessment, but this metric still requires further evaluation with a larger cohort. (C) 2017 American Society for Blood and Marrow Transplantation.

引用

页码：2118 / 2126

页数：9

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