Refined disease risk index for survival after allogeneic hematopoietic cell transplantation (HCT)

Disease type and stage				Risk group
Leukemia/MDS/MPN	CLL/SLL		CR or PR	Low
	CLL/SLL		Stable or progressive	Intermediate
	CML		Chronic phase	Low
			Accelerated phase	Intermediate
			Blast crisis	Very high
	AML	Favorable cytogenetics	CR	Low
		Favorable cytogenetics	Induction failure or active relapse	High
		Intermediate cytogenetics	CR	Intermediate
		Intermediate cytogenetics	Induction failure or active relapse	High
		Adverse cytogenetics	CR	High
		Adverse cytogenetics	Induction failure or active relapse	Very high
	ALL		First CR	Intermediate
			Second or third CR	High
			Induction failure or active relapse	Very high
	Low-risk MDS (<5 percent blasts)	Intermediate cytogenetics	Any stage	Intermediate
		Adverse cytogenetics	Early stage	Intermediate
		Adverse cytogenetics	Induction failure or active relapse	High
	High-risk MDS (≥5 percent blasts)	Intermediate cytogenetics	Early stage	Intermediate
		Intermediate cytogenetics	Induction failure or active relapse	High
		Adverse cytogenetics	Any stage	High
	MPN		Any stage	Intermediate
Lymphoma	Hodgkin lymphoma		CR	Low
	Mantle cell lymphoma		CR	Low
			PR	Intermediate
			Induction failure or active relapse	High
	Clinically indolent B cell NHL		CR or PR	Low
	Clinically aggressive B cell NHL		CR or PR	Intermediate
	Clinically aggressive B cell NHL		Induction failure or active relapse	Very high
	Burkitt lymphoma		CR	High
	Burkitt lymphoma		PR, induction failure, or active relapse	Very high
	T cell NHL		CR or PR	Intermediate
	T cell NHL		Induction failure or active relapse	High
Multiple myeloma			CR or PR	Intermediate
Multiple myeloma			Relapsed/refractory disease	High
Risk group	Percentage of cases		Estimated two-year overall survival (95% CI)
Low	14		66 percent (63 to 68 percent)
Intermediate	63		51 percent (50 to 52 percent)
High	20		33 percent (31 to 35 percent)
Very high	4		23 percent (20 to 27 percent)

A refined disease risk index (DRI) was created by the Center for International Blood and Marrow Transplant Research (CIBMTR) based on data from 13,131 patients who underwent myeloablative, nonmyeloablative, or reduced intensity conditioning followed by allogeneic HCT between 2008 and 2010. The DRI combines information on disease type and status in order to identify "low", "intermediate", "high", and "very high" risk patient populations with significantly different estimated overall survival at two years. For AML, t(8;21), inv(16), and t(15;17) were classified as favorable cytogenetics, complex karyotype (4+ abnormalities) as adverse cytogenetics, and all others as intermediate; for MDS, abnormal chromosome 7 and complex karyotype (≥4 abnormalities) were classified as adverse cytogenetics, and all others as intermediate.

MDS: myelodysplastic syndrome; MPN: myeloproliferative neoplasms; CLL: chronic lymphocytic leukemia; SLL: small lymphocytic lymphoma; CR: complete remission; PR: partial remission; CML: chronic myeloid leukemia; AML: acute myeloid leukemia; ALL: acute lymphoblastic leukemia; NHL: non-Hodgkin lymphoma; HCT: hematopoietic cell transplantation.

Data from: Armand P, Kim HT, Logan BR, et al. Validation and refinement of the disease risk index for allogeneic stem cell transplantation: a study from the CIBMTR. Blood 2014; 123:3664.

Graphic 95118 Version 1.0

خرید پکیج

Refined disease risk index for survival after allogeneic hematopoietic cell transplantation (HCT)