European Group for Blood and Marrow Transplantation score correlates with outcomes of older patients undergoing allogeneic hematopoietic stem cell transplantation

Sheng Hsuan Chien, Yao Chung Liu, Chia Jen Liu, Po Shen Ko, Hao Yuan Wang, Liang Tsai Hsiao, Jeong Shi Lin, Tzeon Jye Chiou, Chun Yu Liu, Jyh Pyng Gau

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are hematological diseases predominantly occurring in older patients. Although allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains the curative therapy for refractory AML or high-risk MDS, old age is often a hurdle to the procedure. We conducted a retrospective study to analyze the prognostic factors predicting outcomes of older patients undergoing allo-HSCT for acute leukemia and MDS. Methods: We collected data from patients diagnosed with acute leukemia or MDS, who underwent allo-HSCT at >50 years of age and reviewed clinical characteristics, including age, sex, underlying disease, European Group for Blood and Bone Marrow Transplantation (EBMT) risk score, and presence of acute graft-versus-host disease (aGVHD) or chronic GVHD (cGVHD). The Cox proportional hazard model was adopted to explore the independent prognostic factors for overall survival (OS), progression-free survival (PFS), and non-relapse mortality (NRM). Results: A total of 85 older patients were included, with the median age at allo-HSCT being 55 years. The significant prognostic factors for worse OS or PFS were an EBMT risk score > 3 and grade III-IV aGVHD, while patients with moderate to severe cGVHD would have better OS or PFS. Interestingly, it is not cGVHD but grade III-IV aGVHD that significantly correlated with NRM. Conclusion: This cohort study suggests that an EBMT risk score >3 and grade III-IV aGVHD predict poor outcomes, and careful management of GVHD may allow better survival for older patients undergoing allo-HSCT.

Original languageEnglish
Pages (from-to)238-244
Number of pages7
JournalJournal of the Chinese Medical Association
Volume83
Issue number3
DOIs
Publication statusPublished - 2020
Externally publishedYes

Keywords

  • Acute leukemia
  • Allogeneic hematopoietic stem cell transplantation
  • Myelodysplastic syndrome
  • Older patient

ASJC Scopus subject areas

  • Medicine(all)

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