TY - JOUR
T1 - Personalized Prognostic Risk Score for Long-Term Survival for Children with Acute Leukemia after Allogeneic Transplantation
AU - Bitan, Menachem
AU - Ahn, Kwang Woo
AU - Millard, Heather R.
AU - Pulsipher, Michael A.
AU - Abdel-Azim, Hisham
AU - Auletta, Jeffery J.
AU - Brown, Valerie
AU - Chan, Ka Wah
AU - Diaz, Miguel Angel
AU - Dietz, Andrew
AU - Vincent, Marta González
AU - Guilcher, Gregory
AU - Hale, Gregory A.
AU - Hayashi, Robert J.
AU - Keating, Amy
AU - Mehta, Parinda
AU - Myers, Kasiani
AU - Page, Kristin
AU - Prestidge, Tim
AU - Shah, Nirali N.
AU - Smith, Angela R.
AU - Woolfrey, Ann
AU - Thiel, Elizabeth
AU - Davies, Stella M.
AU - Eapen, Mary
N1 - Publisher Copyright:
© 2017 The American Society for Blood and Marrow Transplantation
PY - 2017/9
Y1 - 2017/9
N2 - We studied leukemia-free (LFS) and overall survival (OS) in children with acute myeloid (AML, n = 790) and acute lymphoblastic leukemia (ALL, n = 1096) who underwent transplantation between 2000 and 2010 and who survived for at least 1 year in remission after related or unrelated donor transplantation. Analysis of patient-, disease-, and transplantation characteristics and acute and chronic graft-versus-host disease (GVHD) was performed to identify factors with adverse effects on LFS and OS. These data were used to develop risk scores for survival. We did not identify any prognostic factors beyond 4 years after transplantation for AML and beyond 3 years for ALL. Risk score for survival for AML includes age, disease status at transplantation, cytogenetic risk group, and chronic GVHD. For ALL, the risk score includes age at transplantation and chronic GVHD. The 10-year probabilities of OS for AML with good (score 0, 1, or 2), intermediate (score 3), and poor risk (score 4, 5, 6, or 7) were 94%, 87%, and 68%, respectively. The 10-year probabilities of OS for ALL were 89% and 80% for good (score 0 or 1) and poor risk (score 2), respectively. Identifying children at risk for late mortality with early intervention may mitigate some excess late mortality.
AB - We studied leukemia-free (LFS) and overall survival (OS) in children with acute myeloid (AML, n = 790) and acute lymphoblastic leukemia (ALL, n = 1096) who underwent transplantation between 2000 and 2010 and who survived for at least 1 year in remission after related or unrelated donor transplantation. Analysis of patient-, disease-, and transplantation characteristics and acute and chronic graft-versus-host disease (GVHD) was performed to identify factors with adverse effects on LFS and OS. These data were used to develop risk scores for survival. We did not identify any prognostic factors beyond 4 years after transplantation for AML and beyond 3 years for ALL. Risk score for survival for AML includes age, disease status at transplantation, cytogenetic risk group, and chronic GVHD. For ALL, the risk score includes age at transplantation and chronic GVHD. The 10-year probabilities of OS for AML with good (score 0, 1, or 2), intermediate (score 3), and poor risk (score 4, 5, 6, or 7) were 94%, 87%, and 68%, respectively. The 10-year probabilities of OS for ALL were 89% and 80% for good (score 0 or 1) and poor risk (score 2), respectively. Identifying children at risk for late mortality with early intervention may mitigate some excess late mortality.
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U2 - 10.1016/j.bbmt.2017.05.011
DO - 10.1016/j.bbmt.2017.05.011
M3 - Article
C2 - 28527984
AN - SCOPUS:85020896551
SN - 1083-8791
VL - 23
SP - 1523
EP - 1530
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 9
ER -