Comparison of dipss and mysec-pm for prediction of outcome in post-pv and et myelofibrosis after allogeneic stem-cell transplantation - Université de Lille Accéder directement au contenu
Article Dans Une Revue Biology of Blood and Marrow Transplantation Année : 2019

Comparison of dipss and mysec-pm for prediction of outcome in post-pv and et myelofibrosis after allogeneic stem-cell transplantation

Nico Gagelmann
  • Fonction : Auteur
Diderik-Jan Eikema
  • Fonction : Auteur
Liesbeth C. de Wreede
  • Fonction : Auteur
Linda Koster
  • Fonction : Auteur
Christine Wolschke
  • Fonction : Auteur
Renate Arnold
  • Fonction : Auteur
Lothar Kanz
  • Fonction : Auteur
Grant Mcquaker
  • Fonction : Auteur
Tony Marchand
  • Fonction : Auteur
Gerard Socie
  • Fonction : Auteur
Jan J. Cornelissen
  • Fonction : Auteur
Patrice Chevallier
  • Fonction : Auteur
Paolo Bernasconi
  • Fonction : Auteur
Matthias Stelljes
  • Fonction : Auteur
Pierre-Simon Rohrlich
  • Fonction : Auteur
Renato Fanin
  • Fonction : Auteur
Jurgen Finke
  • Fonction : Auteur
Johan Maertens
  • Fonction : Auteur
Didier Blaise
Maija Itala-Remes
  • Fonction : Auteur
Helene Labussiere-Wallet
  • Fonction : Auteur
Marie Robin
  • Fonction : Auteur
Donal Mclornan
  • Fonction : Auteur
Yves Chalandon
  • Fonction : Auteur
Nicolaus Kroger
  • Fonction : Auteur

Résumé

We aimed to validate the MYelofibrosis SECondary to PV and ET prognostic model (MYSEC-PM) in 159 patients with myelofibrosis secondary to polycythemia vera (PV) and essential thrombocythemia (ET) from the European Society for Blood and Marrow Transplantation registry undergoing transplantation from matched siblings or unrelated donors. Furthermore, we aimed to test its prognostic performance in comparison with the Dynamic International Prognostic Scoring System (DIPSS). Score performance was analyzed using the concordance index (C): the probability that a patient who experienced an event had a higher risk score than a patient who did not (C > .5 suggesting predictive ability). Median follow-up of the total cohort was 41 months (range, 34 to 54), 45 months in post-PV and 38 months in post-ET myelofibrosis. Survival at 1, 2, and 4 years was 70% (95% CI, 63% to 77%), 61% (95% CI, 53% to 69%), and 52% (95% CI, 43% to 61%) for the total cohort; 70% (95% CI, 59% to 80%), 61% (95% CI, 49% to 73%), and 51% (95% CI, 38% to 64%) for post-PV; and 71% (95% CI, 61% to 81%), 61% (95% CI, 50% to 72%), and 54% (95% CI, 42% to 66%) for post-ET myelofibrosis (P = .78). Overall, the DIPSS was not significantly predictive of outcome (P = .28). With respect to the MYSEC-PM, overall survival at 4 years was 69% for the low-risk, 55% for the intermediate 1-risk, 47% for the intermediate 2-risk, and 22% (0% to 45%) for the high-risk groups. The prognostic model was predictive of survival overall (P = .05), whereas groups with intermediate 2 and high risk showed no significant difference (P = .44). Assessment of prognostic utility yielded a C-index of .575 (95% CI, .502 to .648) for the DIPSS, whereas assessment of the MYSEC-PM resulted in a C-statistics of .636 (95% CI, .563 to .708), indicating improvement in prediction of post-transplant survival using the new MYSEC-PM. In addition, transplantations from an unrelated donor in comparison with an HLA-identical sibling showed worse outcome (P = .04), and transplant recipients seropositive for cytomegalovirus in comparison with seronegative recipients (P = .01) showed worse survival. In conclusion, incorporating transplant-specific and clinical and mutational information together with the MYSEC-PM may enhance risk stratification.

Dates et versions

hal-04427163 , version 1 (30-01-2024)

Identifiants

Citer

Nico Gagelmann, Diderik-Jan Eikema, Liesbeth C. de Wreede, Linda Koster, Christine Wolschke, et al.. Comparison of dipss and mysec-pm for prediction of outcome in post-pv and et myelofibrosis after allogeneic stem-cell transplantation. Biology of Blood and Marrow Transplantation, 2019, Biology of Blood and Marrow Transplantation, 25, pp.e204-e208. ⟨10.1016/j.bbmt.2019.03.024⟩. ⟨hal-04427163⟩
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