TY - JOUR
T1 - An early post-transplant relapse prediction score in multiple myeloma
T2 - a large cohort study from the chronic malignancies working party of EBMT
AU - Beksac, Meral
AU - Iacobelli, Simona
AU - Koster, Linda
AU - Cornelissen, Jan
AU - Griskevicius, Laimonas
AU - Rabin, Neil K.
AU - Stoppa, Anne Marie
AU - Meijer, Ellen
AU - Mear, Jean Baptiste
AU - Zeerleder, Sacha
AU - Mayer, Jiri
AU - Fenk, Roland
AU - Fegueux, Nathalie
AU - Chevallier, Patrice
AU - Konirova, Eva
AU - Snowden, John A.
AU - Engelhardt, Monika
AU - Orchard, Kim
AU - Hulin, Cyrille
AU - Schaap, Nicolaas
AU - Sossa, Claudia
AU - Elmaagacli, Ahmet
AU - McLornan, Donal P.
AU - Hayden, Patrick J.
AU - Schönland, Stefan
AU - Yakoub-Agha, Ibrahim
N1 - Funding Information:
The study has been performed within the EBMT database utilizing EBMT resources. SI has performed the statistical analysis that led to this novel ER risk-calculating model.
Publisher Copyright:
© 2023, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/8
Y1 - 2023/8
N2 - Early relapse (ER) following Autologous Hematopoietic Cell Transplantation (AHCT) confers a poor prognosis. We therefore developed a novel scoring system to predict ER. A total of 14,367 AHCT-1 patients were transplanted between 2014 and 2019, and were conditioned with Melphalan 200 mg/m2 (Mel200) (n = 7228; 2014–2017) (training cohort); Mel200 (n = 5616; 2018–2019) or Mel140 (n = 1523; 2018–2019) (validation cohorts). PFS-12 and the Cumulative Incidence of Relapse at 12 months were 84.1% and 14.7% (training Mel200), 87.2% and 11.6% (validation Mel200), and 80.3% and 16.9% (validation Mel140), respectively. The points in the risk score were: 0, 1,2 for ISS stages I, II, and III; Disease status: 0 (CR/VGPR); 1 (PR); 2 (SD/MR); 4 (Relapse/Progression); and 1 for Karnofsky ≤ 70. The distribution of scores: 0 (24%), 1 (33.9%), 2 (29.6 %), 3 (9.5%), and ≥4 (2.7%). The score separated PFS-12, with the lowest risk group (n = 1752) having a PFS-12 of 91.7% and the highest risk group (n = 195) 57.1%. This also applied in cytogenetically high-risk patients. If the pre-score baseline risks are 15% (standard risk) and 25% (high-risk), a score of ≥4 confers calculated risks of 38% and 54%, respectively. This novel EBMT ER score, therefore, allows for the identification of five discrete prognostic groups.
AB - Early relapse (ER) following Autologous Hematopoietic Cell Transplantation (AHCT) confers a poor prognosis. We therefore developed a novel scoring system to predict ER. A total of 14,367 AHCT-1 patients were transplanted between 2014 and 2019, and were conditioned with Melphalan 200 mg/m2 (Mel200) (n = 7228; 2014–2017) (training cohort); Mel200 (n = 5616; 2018–2019) or Mel140 (n = 1523; 2018–2019) (validation cohorts). PFS-12 and the Cumulative Incidence of Relapse at 12 months were 84.1% and 14.7% (training Mel200), 87.2% and 11.6% (validation Mel200), and 80.3% and 16.9% (validation Mel140), respectively. The points in the risk score were: 0, 1,2 for ISS stages I, II, and III; Disease status: 0 (CR/VGPR); 1 (PR); 2 (SD/MR); 4 (Relapse/Progression); and 1 for Karnofsky ≤ 70. The distribution of scores: 0 (24%), 1 (33.9%), 2 (29.6 %), 3 (9.5%), and ≥4 (2.7%). The score separated PFS-12, with the lowest risk group (n = 1752) having a PFS-12 of 91.7% and the highest risk group (n = 195) 57.1%. This also applied in cytogenetically high-risk patients. If the pre-score baseline risks are 15% (standard risk) and 25% (high-risk), a score of ≥4 confers calculated risks of 38% and 54%, respectively. This novel EBMT ER score, therefore, allows for the identification of five discrete prognostic groups.
UR - http://www.scopus.com/inward/record.url?scp=85159011675&partnerID=8YFLogxK
U2 - 10.1038/s41409-023-01999-1
DO - 10.1038/s41409-023-01999-1
M3 - Article
C2 - 37160942
AN - SCOPUS:85159011675
SN - 0268-3369
VL - 58
SP - 916
EP - 923
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 8
ER -