Canterbury DHB
In a CIBMTR study, Arora et al identified 10 risk factors which were significant for outcome in multi-variate analysis of 5343 patients who had undergone an allogeneic transplant from a related or unrelated donor for AML, ALL, MDS or CML between 1995-2004. These 10 variables were used to identify six risk groups.
Risk factor |
0 |
1 |
2 |
Age (years) |
<29 |
30-59 |
>60 |
Prior acute GvHD |
None |
Present |
|
Time from transplantation to cGvHD |
>5 months |
<5 months |
|
Serum bilirubin at cGvHD onset |
<2 mg/dl </=34 |
>2 mg/dl >34 |
|
KPS at cGvHD onset |
>/=80 |
<80 |
|
Platelet count at cGvHD onset |
</=100 |
>100 |
|
Type of donor |
HLA-identical sibling 7/8 or 8/8 MUD |
Other related/mismatched MUD |
|
Disease status at transplant1 |
Early |
Intermediate |
Advanced |
Sex mismatch (donor/recipient) |
M/M, M/F, F/F |
F/M |
|
GvHD prophylaxis |
CSA+MTX+other |
Tacrolimus+MTX +other or TCD |
|
Early disease = allograft in CR1 (acute leukemia) or first chronic phase (CML) or MDS categories RA or RARS; Intermediate disease = CR2 or later (ALL) or second chronic phase/accelerated phase or later (CML); Advanced disease = patients in relapse or with refractory disease (acute leukemia) or blast crisis (CML) or MDS categories RAEB or RAEB in transformation.
5-year OS and NRM according to the cGvHD score |
|||
Score |
Risk group |
OS |
NRM |
0-2 |
1 |
91 |
4.6 |
3-6 |
2 |
67 |
20 |
7-8 |
3 |
51 |
33 |
9-10 |
4 |
40 |
43 |
11 |
5 |
21 |
63 |
>12 |
6 |
4 |
72 |
>11 |
5+6 |
14.5 |
67 |
Topic Code: 112962