title: A prognostic score for patients with acute leukemia or myelodysplastic syndromes undergoing allogeneic stem cell transplantation.
abstract: Allogeneic hematopoietic stem cell transplantation (SCT) has the potential to cure patients with acute leukemia or myelodysplastic syndromes (MDS), but a number of prognostic factors can influence the outcome of transplantation. At present, no transplantation-specific risk score exists for this patient population. We propose a simple scoring system for patients with acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL), or MDS, based on a retrospective analysis of 445 patients undergoing SCT at our institution (divided into training and validation subsets). The score depends on 5 variables: age, disease, stage at transplantation, cytogenetics, and pretransplantation ferritin. It divides patients into 3 groups of comparable size, with 5-year overall survival (OS) of 56% (low risk), 22% (intermediate risk), and 5% (high risk). This prognostic score could be useful in making treatment decisions for individual patients, in stratifying patients entering clinical trials, and in adjusting transplantation outcomes across centers under the new federal reporting rules.
authors.affiliation: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts 02115, USA. parmand@partners.org
authors.forename: Philippe
authors.initials: P
authors.lastname: Armand
authors.forename: Haesook T
authors.initials: HT
authors.lastname: Kim
authors.forename: Corey S
authors.initials: CS
authors.lastname: Cutler
authors.forename: Vincent T
authors.initials: VT
authors.lastname: Ho
authors.forename: John
authors.initials: J
authors.lastname: Koreth
authors.forename: Jerome
authors.initials: J
authors.lastname: Ritz
authors.forename: Edwin P
authors.initials: EP
authors.lastname: Alyea
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Antin
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Soiffer
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D020732:Cytogenetic Analysis; D018572:Disease-Free Survival; D005260:Female; D005293:Ferritins; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000145:classification* / Q000473:pathology / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009190:Myelodysplastic Syndromes / Q000145:classification* / Q000473:pathology / Q000628:therapy; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000145:classification* / Q000473:pathology / Q000628:therapy; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014184:Transplantation, Homologous
chemical_list: D005293:Ferritins