Redefining and measuring transplant conditioning intensity in current era: a study in acute myeloid leukemia patients View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2020-01-29

AUTHORS

Alexandros Spyridonidis, Myriam Labopin, Bipin N. Savani, Riitta Niittyvuopio, Didier Blaise, Charles Craddock, Gerard Socié, Uwe Platzbecker, Dietrich Beelen, Noel Milpied, Jan J. Cornelissen, Arnold Ganser, Anne Huynh, Laimonas Griskevicius, Sebastian Giebel, Mahmoud Aljurf, Eolia Brissot, Florent Malard, Jordi Esteve, Zinaida Peric, Frédéric Baron, Annalisa Ruggeri, Christoph Schmid, Maria Gilleece, Norbert-Claude Gorin, Francesco Lanza, Roni Shouval, Jurjen Versluis, Gesine Bug, Yngvar Fløisand, Fabio Ciceri, Jamie Sanz, Ali Bazarbachi, Arnon Nagler, Mohamad Mohty

ABSTRACT

To address limitations of the currently used reduced-intensity/myeloablative conditioning (RIC/MAC) classification scheme we aimed to develop a tool that can capture more standardized the conditioning intensity of allogeneic hematopoietic cell transplantation (HCT). We assigned intensity weight scores for frequently used conditioning regimen components and used their sum to generate the transplant conditioning intensity (TCI) score. We retrospectively tested the impact of TCI on 8255 adult (45–65 years) acute myeloid leukemia patients who underwent HCT in first complete remission. A Cox model for early nonrelapse mortality (NRM) yielded a 3-group TCI risk scheme (low, intermediate, high) with respective TCI scores of [1–2], [2.5–3.5] and [4–6]. On multivariate modeling, TCI grouping was highly and better predictive for early (day 100 and 180) NRM, 2-year NRM and relapse (REL) as compared with the RIC/MAC classification. Validation was done on 200 bootstrap samples. Moreover, TCI scoring enabled the identification of a distinct subgroup of RIC and MAC conditioning regimens with an intermediate TCI [2.5–3.5] score that had identical outcomes and which are frequently referred as “reduced toxicity conditioning”. TCI scheme provides an improvement of the RIC/MAC classification. We propose TCI as a new tool to define and measure the conditioning regimen intensity. More... »

PAGES

1114-1125

Journal

TITLE

Bone Marrow Transplantation

ISSUE

6

VOLUME

55

Author Affiliations

  • Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece
  • Service d’ Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France
  • Long term Transplant Clinic, Vanderbilt University Medical Center, Nashville, TN, USA
  • HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland
  • Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France
  • University Hospital Birmingham NHS Trust, Birmingham, UK
  • Department of Hematology-BMT, Hospital St. Louis, Paris, France
  • Hematology and Cellular Therapy, University Hospital, Leipzig, Germany
  • Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital of Essen, Essen, Germany
  • CHU Bordeaux, Hospital Haut-Leveque, Pessac, France
  • Erasmus MC Cancer Institute, Department of Hematology, Erasmus University Medical Center, Rotterdam, The Netherlands
  • Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
  • CHU - Institut Universitaire du Cancer Toulouse, Oncopole, I.U.C.T-O, Toulouse, France
  • Hematology, Oncology & Transfusion Center, Vilnius University Hospital Santaros Klinikos, Vilnius University, Vilnius, Lithuania
  • Department of Bone Marrow Transplantation and Oncohematology, Maria Sklodowska-Curie Memorial Cencer Center and Institute of Oncology, Gliwice, Poland
  • Oncology Center, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
  • Hematology Department, IDIBAPS, Hospital Clinic, Barcelona, Spain
  • Department of Internal Medicine, University Hospital Centre Zagreb, School of Medicine, Zagreb, Croatia
  • GIGA-I3 Hematology, University and CHU of Liège, Liège, Belgium
  • Department of Pediatric Hematology and Oncology, IRCCS Bambino Gesù Children’s Hospital, Roma, Italy
  • Department of Hematology and Oncology, Universitäts-Klinikum Augsburg, Augsburg, Germany
  • Leeds Teaching Hospitals Trust, Leeds, UK
  • Hematology and Romagna Metropolitan Transplant Network, Hospital of Ravenna, Ravenna, Italy
  • Adult BMT Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
  • Department of Medicine 2, Hematology and Oncology, University Hospital, Goethe University, Frankfurt, Germany
  • Department of Hematology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
  • Hematology and BMT Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
  • Hematology Department, University Hospital La Fe, Valencia, Spain
  • Bone Marrow Transplantation Program, American University of Beirut, Medical Center, Beirut, Lebanon
  • Hematology Division, BMT and Cord Blood Bank, Chaim Sheba Medical Center, Tel-Hashomer, Israel
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/s41409-020-0803-y

    DOI

    http://dx.doi.org/10.1038/s41409-020-0803-y

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1124369413

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/31996792


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