Validation of the transplant conditioning intensity (TCI) index for allogeneic hematopoietic cell transplantation.

Journal

Bone marrow transplantation

ISSN: 1476-5365

Titre abrégé: Bone Marrow Transplant

Pays: England

ID NLM: 8702459

Informations de publication

Date de publication:
17 Nov 2023

Historique:

received: 05 03 2023

accepted: 18 10 2023

revised: 05 10 2023

medline: 18 11 2023

pubmed: 18 11 2023

entrez: 18 11 2023

Statut: aheadofprint

Résumé

The intensity of the conditioning regimen given before allogeneic hematopoietic cell transplantation (allo-HCT) can vary substantially. To confirm the ability of the recently developed transplant conditioning intensity (TCI) score to stratify the preparative regimens of allo-HCT, we used an independent and contemporary patient cohort of 4060 transplant recipients with acute myeloid leukemia meeting inclusion criteria from the discovery study (allo-HCT in first complete remission, matched donor), but who were allografted in a more recent period (2018-2021) and were one decade older (55-75 years, median 63.4 years), we assigned them to a TCI category (low n = 1934, 48%; intermediate n = 1948, 48%, high n = 178, 4%) according to the calculated TCI score ([1-2], [2.5-3.5], [4-6], respectively), and examined the validity of the TCI category in predicting early non-relapse mortality (NRM), 2-year NRM and relapse (REL). In the unadjusted comparison, the TCI index provided a significant risk stratification for d100 and d180 NRM, NRM and REL risk. In the multivariate analysis adjusted for significant variables, there was an independent association of TCI with early NRM, NRM and REL. In summary, we confirm in contemporary treated patients that TCI reflects the conditioning regimen related morbidity and anti-leukemic efficacy satisfactorily and across other established prognostic factors.

Identifiants

DOI: 10.1038/s41409-023-02139-5 PMID: 37978322

pubmed: 37978322

doi: 10.1038/s41409-023-02139-5

pii: 10.1038/s41409-023-02139-5

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Références

Bacigalupo A, Ballen K, Rizzo D, Giralt S, Lazarus H, Ho V, et al. Defining the intensity of conditioning regimens: working definitions. Biol Blood Marrow Transpl J Am Soc Blood Marrow Transpl. 2009;15:1628–33.

doi: 10.1016/j.bbmt.2009.07.004

Giralt S, Ballen K, Rizzo D, Bacigalupo A, Horowitz M, Pasquini M, et al. Reduced-intensity conditioning regimen workshop: defining the dose spectrum. Report of a workshop convened by the center for international blood and marrow transplant research. Biol Blood Marrow Transpl J Am Soc Blood Marrow Transpl. 2009;15:367–9.

doi: 10.1016/j.bbmt.2008.12.497

Gyurkocza B, Sandmaier BM. Conditioning regimens for hematopoietic cell transplantation: one size does not fit all. Blood. 2014;124:344–53.

doi: 10.1182/blood-2014-02-514778 pubmed: 24914142 pmcid: 4102707

Duque-Afonso J, Finke J, Labopin M, Craddock C, Protheroe R, Kottaridis P, et al. Comparison of fludarabine-melphalan and fludarabine-treosulfan as conditioning prior to allogeneic hematopoietic cell transplantation-a registry study on behalf of the EBMT Acute Leukemia Working Party. Bone Marrow Transpl. 2022;57:1269–76.

doi: 10.1038/s41409-022-01646-1

Gavriilaki E, Labopin M, Sakellari I, Salmenniemi U, Yakoub-Agha I, Potter V, et al. Comparative study of treosulfan plus Fludarabine (FT14) with busulfan plus Fludarabine (FB4) for acute myeloid leukemia in first or second complete remission: an analysis from the European Society for Blood and Marrow Transplantation (EBMT) Acute Leukemia Working Party (ALWP). Bone Marrow Transplant. 2022;57:1803–9.

Le Bourgeois A, Labopin M, Marçais A, de Latour RP, Blaise D, Chantepie S, et al. Sequential allogeneic hematopoietic stem cell transplantation for active refractory/relapsed myeloid malignancies: results of a reduced-intensity conditioning preceded by clofarabine and cytosine arabinoside, a retrospective study on behalf of the SFGM-TC. Ann Hematol. 2020;99:1855–62.

doi: 10.1007/s00277-020-04074-7 pubmed: 32564196

Rodríguez-Arbolí E, Labopin M, Tischer J, Brecht A, Ganser A, Finke J, et al. FLAMSA-based reduced-intensity conditioning versus myeloablative conditioning in younger patients with relapsed/refractory acute myeloid leukemia with active disease at the time of allogeneic stem cell transplantation: an analysis from the acute leukemia Working Party of the European Society for Blood and Marrow Transplantation. Biol Blood Marrow Transpl J Am Soc Blood Marrow Transpl. 2020;26:2165–73.

doi: 10.1016/j.bbmt.2020.07.020

Spyridonidis A, Labopin M, Savani BN, Niittyvuopio R, Blaise D, Craddock C, et al. Redefining and measuring transplant conditioning intensity in current era: a study in acute myeloid leukemia patients. Bone Marrow Transpl. 2020;55:1114–25.

doi: 10.1038/s41409-020-0803-y

Kanate AS, Nagler A, Savani B. Summary of scientific and statistical methods, study endpoints and definitions for observational and registry-based studies in hematopoietic cell transplantation. Clin Hematol Int. 2019;2:2–4.

doi: 10.2991/chi.d.191207.001 pubmed: 34595436 pmcid: 8432337

Maakaron JE, Zhang M-J, Chen K, Abhyankar S, Bhatt VR, Chhabra S, et al. Age is no barrier for adults undergoing HCT for AML in CR1: contemporary CIBMTR analysis. Bone Marrow Transpl. 2022;57:911–7.

doi: 10.1038/s41409-022-01650-5

Muffly L, Pasquini MC, Martens M, Brazauskas R, Zhu X, Adekola K, et al. Increasing use of allogeneic hematopoietic cell transplantation in patients aged 70 years and older in the United States. Blood. 2017;130:1156–64.

doi: 10.1182/blood-2017-03-772368 pubmed: 28674027 pmcid: 5580273

Ringdén O, Boumendil A, Labopin M, Canaani J, Beelen D, Ehninger G, et al. Outcome of allogeneic hematopoietic stem cell transplantation in patients age >69 years with acute myelogenous leukemia: on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation. Biol Blood Marrow Transpl J Am Soc Blood Marrow Transpl. 2019;25:1975–83.

doi: 10.1016/j.bbmt.2019.05.037

Eapen M, Brazauskas R, Hemmer M, Perez WS, Steinert P, Horowitz MM, et al. Hematopoietic cell transplant for acute myeloid leukemia and myelodysplastic syndrome: conditioning regimen intensity. Blood Adv. 2018;2:2095–103.

doi: 10.1182/bloodadvances.2018021980 pubmed: 30135184 pmcid: 6113615

Saraceni F, Scortechini I, Fiorentini A, Dubbini MV, Mancini G, Federici I, et al. Conditioning regimens for frail patients with acute leukemia undergoing allogeneic stem cell transplant: how to strike gently. Clin Hematol Int. 2021;3:153–60.

doi: 10.2991/chi.k.210731.001 pubmed: 34938987 pmcid: 8690700

Passweg JR, Baldomero H, Chabannon C, Basak GW, de la Cámara R, Corbacioglu S, et al. Hematopoietic cell transplantation and cellular therapy survey of the EBMT: monitoring of activities and trends over 30 years. Bone Marrow Transpl. 2021;56:1651–64.

doi: 10.1038/s41409-021-01227-8

Hourigan CS, Dillon LW, Gui G, Logan BR, Fei M, Ghannam J, et al. Impact of conditioning intensity of allogeneic transplantation for acute myeloid leukemia with genomic evidence of residual disease. J Clin Oncol J Am Soc Clin Oncol. 2020;38:1273–83.

doi: 10.1200/JCO.19.03011

Nagler A, Peczynski C, Dholaria B, Labopin M, Valerius T, Dreger P, et al. Impact of conditioning regimen intensity on outcomes of second allogeneic hematopoietic cell transplantation for secondary acute myelogenous leukemia. Bone Marrow Transpl. 2022;57:1116–23.

doi: 10.1038/s41409-022-01693-8

Shouval R, Fein JA, Shouval A, Danylesko I, Shem-Tov N, Zlotnik M, et al. External validation and comparison of multiple prognostic scores in allogeneic hematopoietic stem cell transplantation. Blood Adv. 2019;3:1881–90.

doi: 10.1182/bloodadvances.2019032268 pubmed: 31221661 pmcid: 6595255

Sorror ML, Storb RF, Sandmaier BM, Maziarz RT, Pulsipher MA, Maris MB, et al. Comorbidity-age index: a clinical measure of biologic age before allogeneic hematopoietic cell transplantation. J Clin Oncol J Am Soc Clin Oncol. 2014;32:3249–56.

doi: 10.1200/JCO.2013.53.8157

Armand P, Kim HT, Logan BR, Wang Z, Alyea EP, Kalaycio ME, et al. Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation. Blood. 2014;123:3664–71.

doi: 10.1182/blood-2014-01-552984 pubmed: 24744269 pmcid: 4047501

Shouval R, Fein JA, Labopin M, Cho C, Bazarbachi A, Baron F, et al. Development and validation of a disease risk stratification system for patients with haematological malignancies: a retrospective cohort study of the European Society for Blood and Marrow Transplantation registry. Lancet Haematol. 2021;8:e205–15.

doi: 10.1016/S2352-3026(20)30394-X pubmed: 33636142 pmcid: 9190021

Potdar R, Varadi G, Fein J, Labopin M, Nagler A, Shouval R. Prognostic scoring systems in allogeneic hematopoietic stem cell transplantation: where do we stand? Biol Blood Marrow Transpl J Am Soc Blood Marrow Transpl. 2017;23:1839–46.

doi: 10.1016/j.bbmt.2017.07.028

Duléry R, Mohty R, Labopin M, Sestili S, Malard F, Brissot E, et al. Early cardiac toxicity associated with post-transplant cyclophosphamide in allogeneic stem cell transplantation. JACC CardioOncol. 2021;3:250–9.

doi: 10.1016/j.jaccao.2021.02.011 pubmed: 34396331 pmcid: 8352028