Copelan, Edward
Mayo Clinic
Brian C. Shaffer and Martin Tallman, Memorial Sloan Kettering Cancer Center; Adriana K. Malone, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai; Ran Reshef, Columbia University Medical Center, New York; Mark Litzow, Mayo Clinic Rochester; J
Citations 1
Scoring System Prognostic of Outcome in Patients Undergoing Allogeneic Hematopoietic Cell Transplantation for Myelodysplastic Syndrome
Shaffer, Brian C. , Ahn, Kwang Woo , Hu, Zhen‐Huan , Malone, Adriana K. , Valcárcel, David , Hamilton, Betty K. , Kharfan‐Dabaja, Mohamed A. , Saad, Ayman , Warlick, Erica D. , Wirk, Baldeep , Sabloff, Mitchell , Fasan, Omotayo , Gerds, Aaron T. , Marks, David I. , Olsson, Richard F. , Wood, William A. , Costa, Luciano J. , Miller, Alan M. , Cortes, Jörge E. , Daly, Andrew , Kindwall‐Keller, Tamila L. , Kamble, Rammurti T., Rizzieri, David A. , Cahn, Jean‐Yves , William, Basem M. , Litzow, Mark R. , Wiernik, Peter H. , Vij, Ravi , Üstün, Celalettin , Copelan, Edward A. , Kalaycio, Matt, Alyea, Edwin P. , Sobecks, R., Pavletic, Steven Z. , Tallman, Martin S. , Saber, Wael , Nishihori, Taiga , Bacher, Ulrike , Hamilton, Betty, Kharfan-Dabaja, Mohamed A., Cutler, Corey, Warlick, Erica, Wirk, Baldeep Mona, Marks, David, Olsson, Richard, Wood, William Allen, Cortes, Jorge, Kindwall-Keller, Tamila L, Kamble, Rammurti, William, Basem, Savani, Bipin N. , Copelan, Edward, Popat, Uday, Maziarz, Richard, Alyea, Edwin, Sobecks, Ron, Pavletic, Steven, Tallman, Martin, Grunwald, Michael R. , Cutler, Corey S. , Reshef, Ran , Gale, Robert Peter , Liesveld, Jane L. , Popat, Uday R , Maziarz, Richard Thomas , Gerds, Aaron T , Saad, Ayman , Olsson, Richard F , Cortes, Jorge , William, Basem , Costa, Luciano J , Sabloff, Mitchell , Wood, William A , Valcárcel, David
Journal of Clinical Oncology | April 5, 2016 | Volume: 34 | Issue: 16 | Pages: 1864-1871
Purpose To develop a system prognostic of outcome in those undergoing allogeneic hematopoietic cell transplantation (allo HCT) for myelodysplastic syndrome (MDS). Patients and Methods We examined 2,133 patients with MDS undergoing HLA-matched (n = 1,728) or -mismatched (n = 405) allo HCT from 2000 to 2012. We used a Cox multivariable model to identify factors prognostic of mortality in a training subset (n = 1,151) of the HLA-matched cohort. A weighted score using these factors was assigned to the remaining patients undergoing HLA-matched allo HCT (validation cohort; n = 577) as well as to patients undergoing HLA-mismatched allo HCT. Results Blood blasts greater than 3% (hazard ratio [HR], 1.41; 95% CI, 1.08 to 1.85), platelets 50 × 109/L or less at transplantation (HR, 1.37; 95% CI, 1.18 to 1.61), Karnofsky performance status less than 90% (HR, 1.25; 95% CI, 1.06 to 1.28), comprehensive cytogenetic risk score of poor or very poor (HR, 1.43; 95% CI, 1.14 to 1.80), and age 30 to 49 years (HR, 1.60; 95% CI, 1.09 to 2.35) were associated with increased hazard of death and assigned 1 point in the scoring system. Monosomal karyotype (HR, 2.01; 95% CI, 1.65 to 2.45) and age 50 years or older (HR, 1.93; 95% CI, 1.36 to 2.83) were assigned 2 points. The 3-year overall survival after transplantation in patients with low (0 to 1 points), intermediate (2 to 3), high (4 to 5) and very high (≥ 6) scores was 71% (95% CI, 58% to 85%), 49% (95% CI, 42% to 56%), 41% (95% CI, 31% to 51%), and 25% (95% CI, 4% to 46%), respectively (P < .001). Increasing score was predictive of increased relapse (P < .001) and treatment-related mortality (P < .001) in the HLA-matched set and relapse (P < .001) in the HLA-mismatched cohort. Conclusion The proposed system is prognostic of outcome in patients undergoing HLA-matched and -mismatched allo HCT for MDS.