Role of age and hematopoietic cell transplantation-specific comorbidity index in myelodysplastic patients undergoing an allotransplant: a retrospective study from the chronic malignancies working party of the european group for blood and marrow transplantation - Université de Lille Accéder directement au contenu
Article Dans Une Revue Biology of Blood and Marrow Transplantation Année : 2020

Role of age and hematopoietic cell transplantation-specific comorbidity index in myelodysplastic patients undergoing an allotransplant: a retrospective study from the chronic malignancies working party of the european group for blood and marrow transplantation

Martin Carre
  • Fonction : Auteur
Raphael Porcher
  • Fonction : Auteur
Jurgen Finke
  • Fonction : Auteur
Gerhard Ehninger
  • Fonction : Auteur
Linda Koster
  • Fonction : Auteur
Dietrich Beelen
  • Fonction : Auteur
Arnold Ganser
  • Fonction : Auteur
Liisa Volin
  • Fonction : Auteur
Sara Lozano
  • Fonction : Auteur
Lone Friis
  • Fonction : Auteur
Mauricette Michallet
  • Fonction : Auteur
Johanna Tischer
  • Fonction : Auteur
Eduardo Olavarria
  • Fonction : Auteur
Maria Jesus Pascual Cascon
  • Fonction : Auteur
Simona Iacobelli
  • Fonction : Auteur
Yener Koc
  • Fonction : Auteur
Pavel Jindra
  • Fonction : Auteur
Mutlu Arat
  • Fonction : Auteur
Theo de Witte
  • Fonction : Auteur
Nicolaus Kroger
  • Fonction : Auteur
Marie Robin
  • Fonction : Auteur

Résumé

Allogeneic hematopoietic stem cell transplantation (HSCT) remains the only potentially curative option for myelodysplastic syndromes (MDSs) but is severely limited by nonrelapse mortality (NRM), especially in this mostly older population. Comorbidity assessment is crucial to predict NRM and often assessed with the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI). Moreover, the impact of age on NRM still remains a matter of debate. In recent years, the age at which transplants are made has been progressively increasing, and patients with comorbidities have become more common. Extricating the respective roles of age and comorbidities in toxic mortality is all the more important. This study by the European Group for Blood and Marrow Transplantation registry included 1245 adult patients who underwent a first allogeneic stem cell transplantation for MDSs between 2003 and 2014. Overall, 4-year NRM and overall survival were 32% and 47%, respectively. When considered as continuous predictors, HCT-CI score and age were associated with an increased hazard ratio (HR) for NRM. In multivariate analysis, age band (HR, 1.13; 95% CI, 1.02 to 1.25; P= .016), HCT-CI ≥3 (HR, 1.34; 95% CI, 1.04 to 1.73; P = .022), and Karnofsky Performance Status ≤80 (HR, 2.03; 95% CI, 1.52 to 2.73; P< .0001) were significantly predictive of a worse NRM. In our large cohort, both comorbidities, evaluated by the original HCT-CI score, and chronological age significantly affected NRM. Thus, age should be part of the transplant decision-making process and should be integrated in future scoring systems predicting outcomes of HSCT in MDSs.
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Dates et versions

hal-04429117 , version 1 (31-01-2024)

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Martin Carre, Raphael Porcher, Jurgen Finke, Gerhard Ehninger, Linda Koster, et al.. Role of age and hematopoietic cell transplantation-specific comorbidity index in myelodysplastic patients undergoing an allotransplant: a retrospective study from the chronic malignancies working party of the european group for blood and marrow transplantation. Biology of Blood and Marrow Transplantation, 2020, Biology of Blood and Marrow Transplantation, 26, pp.P451-457. ⟨10.1016/j.bbmt.2019.10.015⟩. ⟨hal-04429117⟩

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