Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil
Introduction: The Acute Leukemia-European Society for Blood and Marrow Transplantation (AL-EBMT) risk score was recently developed and validated by Shouval et al. Objective: To assess the ability of this score in predicting the 2-year overall survival (OS-2), leukemia-free survival (LFS-2) and trans...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | Hematology, Transfusion and Cell Therapy |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S253113792100078X |
| _version_ | 1811172221280845824 |
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| author | Gustavo Machado Teixeira Glaucia Helena Martinho Antonio Vaz de Macedo Ana Luiza Roscoe Santoro Marisa Ribeiro Verçosa Fernanda Maia Lodi Vandack Nobre |
| author_facet | Gustavo Machado Teixeira Glaucia Helena Martinho Antonio Vaz de Macedo Ana Luiza Roscoe Santoro Marisa Ribeiro Verçosa Fernanda Maia Lodi Vandack Nobre |
| author_sort | Gustavo Machado Teixeira |
| collection | DOAJ |
| description | Introduction: The Acute Leukemia-European Society for Blood and Marrow Transplantation (AL-EBMT) risk score was recently developed and validated by Shouval et al. Objective: To assess the ability of this score in predicting the 2-year overall survival (OS-2), leukemia-free survival (LFS-2) and transplant-related mortality (TRM) in acute leukemia (AL) adult patients undergoing a first allogeneic hematopoietic stem cell transplant (HSCT) at a transplant center in Brazil. Methods: In this prospective, cohort study, we used the formula published by Shouval et al. to calculate the AL-EBMT score and stratify patients into three risk categories. Results: A total of 79 patients transplanted between 2008 and 2018 were analyzed. The median age was 38 years. Acute myeloid leukemia was the most common diagnosis (68%). Almost a quarter of the cases were at an advanced stage. All hematopoietic stem cell transplantations (HSCTs) were human leukocyte antigen-matched (HLA-matched) and the majority used familial donors (77%). Myeloablative conditioning was used in 92% of the cases. Stratification according to the AL-EBMT score into low-, intermediate- and high-risk groups yielded the following results: 40%, 12% and 47% of the cases, respectively. The high scoring group was associated with a hazard ratio of 2.1 (p = 0.007), 2.1 (p = 0.009) and 2.47 (p = 0.01) for the 2-year OS, LFS and TRM, respectively. Conclusion: This study supports the ability of the AL-EBMT score to reasonably predict the 2-year post-transplant OS, LFS and TRM and to discriminate between risk categories in adult patients with AL, thus confirming its usefulness in clinical decision-making in this setting. Larger, multicenter studies may further help confirm these findings. |
| first_indexed | 2024-04-10T17:26:11Z |
| format | Article |
| id | doaj.art-a945d6b11d3947fdae056182c4dac034 |
| institution | Directory Open Access Journal |
| issn | 2531-1379 |
| language | English |
| last_indexed | 2024-04-10T17:26:11Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj.art-a945d6b11d3947fdae056182c4dac0342023-02-04T04:18:24ZengElsevierHematology, Transfusion and Cell Therapy2531-13792023-01-014513844Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in BrazilGustavo Machado Teixeira0Glaucia Helena Martinho1Antonio Vaz de Macedo2Ana Luiza Roscoe Santoro3Marisa Ribeiro Verçosa4Fernanda Maia Lodi5Vandack Nobre6Hospital das Clínicas da Universidade Federal de Minas Gerais (HC UFMG), Belo Horizonte, MG, Brazil; Hospital Alberto Cavalcanti/ FHEMIG, Belo Horizonte, MG, Brazil; Corresponding author at: Setor de Transplante de Medula Óssea do Hospital das Clínicas da Universidade Federal de Minas Gerais, Avenida Alfredo Balena, 110, Santa Efigênia, Belo Horizonte, MG, Brazil.Hospital das Clínicas da Universidade Federal de Minas Gerais (HC UFMG), Belo Horizonte, MG, BrazilHospital da Polícia Militar de Minas Gerais, Belo Horizonte, MG, BrazilHospital das Clínicas da Universidade Federal de Minas Gerais (HC UFMG), Belo Horizonte, MG, Brazil; Fundação Hemominas, Belo Horizonte, MG, BrazilHospital das Clínicas da Universidade Federal de Minas Gerais (HC UFMG), Belo Horizonte, MG, BrazilHospital das Clínicas da Universidade Federal de Minas Gerais (HC UFMG), Belo Horizonte, MG, BrazilFaculdade de Medicina da Universidade Federal de Minas Gerais (FMUFMG), Belo Horizonte, MG, BrazilIntroduction: The Acute Leukemia-European Society for Blood and Marrow Transplantation (AL-EBMT) risk score was recently developed and validated by Shouval et al. Objective: To assess the ability of this score in predicting the 2-year overall survival (OS-2), leukemia-free survival (LFS-2) and transplant-related mortality (TRM) in acute leukemia (AL) adult patients undergoing a first allogeneic hematopoietic stem cell transplant (HSCT) at a transplant center in Brazil. Methods: In this prospective, cohort study, we used the formula published by Shouval et al. to calculate the AL-EBMT score and stratify patients into three risk categories. Results: A total of 79 patients transplanted between 2008 and 2018 were analyzed. The median age was 38 years. Acute myeloid leukemia was the most common diagnosis (68%). Almost a quarter of the cases were at an advanced stage. All hematopoietic stem cell transplantations (HSCTs) were human leukocyte antigen-matched (HLA-matched) and the majority used familial donors (77%). Myeloablative conditioning was used in 92% of the cases. Stratification according to the AL-EBMT score into low-, intermediate- and high-risk groups yielded the following results: 40%, 12% and 47% of the cases, respectively. The high scoring group was associated with a hazard ratio of 2.1 (p = 0.007), 2.1 (p = 0.009) and 2.47 (p = 0.01) for the 2-year OS, LFS and TRM, respectively. Conclusion: This study supports the ability of the AL-EBMT score to reasonably predict the 2-year post-transplant OS, LFS and TRM and to discriminate between risk categories in adult patients with AL, thus confirming its usefulness in clinical decision-making in this setting. Larger, multicenter studies may further help confirm these findings.http://www.sciencedirect.com/science/article/pii/S253113792100078XPrognostic modelAcute leukemiaEuropean society for blood and marrow transplantationPredictive model scorePredictive model index |
| spellingShingle | Gustavo Machado Teixeira Glaucia Helena Martinho Antonio Vaz de Macedo Ana Luiza Roscoe Santoro Marisa Ribeiro Verçosa Fernanda Maia Lodi Vandack Nobre Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil Hematology, Transfusion and Cell Therapy Prognostic model Acute leukemia European society for blood and marrow transplantation Predictive model score Predictive model index |
| title | Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil |
| title_full | Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil |
| title_fullStr | Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil |
| title_full_unstemmed | Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil |
| title_short | Applicability of the acute leukemia (AL) - EBMT score as a prognostic model for allogeneic hematopoietic stem cell transplantation: a single-center, prospective, cohort study at a reference transplant center in Brazil |
| title_sort | applicability of the acute leukemia al ebmt score as a prognostic model for allogeneic hematopoietic stem cell transplantation a single center prospective cohort study at a reference transplant center in brazil |
| topic | Prognostic model Acute leukemia European society for blood and marrow transplantation Predictive model score Predictive model index |
| url | http://www.sciencedirect.com/science/article/pii/S253113792100078X |
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