title: Risk score for outcome after allogeneic hematopoietic stem cell transplantation: a retrospective analysis.
abstract: BACKGROUND
  It was investigated whether the European Group for Blood and Marrow Transplantation risk score, previously established for chronic myeloid leukemia, could be used to predict outcome after allogeneic hematopoietic stem cell transplantation (HSCT) for hematological disease in general.
  
  
  METHODS
  Age of patient, disease stage, time interval from diagnosis to transplant, donor type, and donor-recipient sex combination were used to establish a score from 0 to 7 points. Its validity was tested in 56,505 patients, 33,113 (58%) male, 23,392 female, median age 33 years (range, 0.5-77 years), with an allogeneic HSCT for a hematological disorder between 1980 and 2005.
  
  
  RESULTS
  Survival probability at 5 years decreased from 71% (95% confidence interval [CI], 69%-73%) for risk score 0 for the whole cohort (75%, 95% CI, 72%-78% for the most recent time cohort) to 24% (95% CI, 21%-27% for risk score 6 and 7; 25%, 95% CI, 22%-29% most recent cohort). Transplant-related mortality increased from 15% (95% CI, 14%-17%) for risk score 0 (11%, 95% CI, 9%-13%, most recent cohort) to 47% with risk score 6 and 7 (95% CI, 44%-50%) for the whole cohort (45%, 95% CI, 42%-48%, most recent cohort). The risk score was predictive in all disease categories, over all time periods, and was not altered by transplant techniques.
  
  
  CONCLUSIONS
  Five well-defined pretransplant patient and donor characteristics give a reasonable risk estimate of allogeneic HSCT. This risk score can provide a basis for the decision between transplant and nontransplant strategies.
authors.affiliation: Department of Hematology, University Hospital, University of Basel, Basel, Switzerland. hematology@uhbs.ch
authors.forename: Alois
authors.initials: A
authors.lastname: Gratwohl
authors.forename: Martin
authors.initials: M
authors.lastname: Stern
authors.forename: Ronald
authors.initials: R
authors.lastname: Brand
authors.forename: Jane
authors.initials: J
authors.lastname: Apperley
authors.forename: Helen
authors.initials: H
authors.lastname: Baldomero
authors.forename: Theo
authors.initials: T
authors.lastname: de Witte
authors.forename: Giorgio
authors.initials: G
authors.lastname: Dini
authors.forename: Vanderson
authors.initials: V
authors.lastname: Rocha
authors.forename: Jakob
authors.initials: J
authors.lastname: Passweg
authors.forename: Anna
authors.initials: A
authors.lastname: Sureda
authors.forename: André
authors.initials: A
authors.lastname: Tichelli
authors.forename: Dietger
authors.initials: D
authors.lastname: Niederwieser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D006402:Hematologic Diseases / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D014184:Transplantation, Homologous