Personalized Prognostic Risk Score for Long-Term Survival for Children with Acute Leukemia after Allogeneic Transplantation

Menachem Bitan, Kwang Woo Ahn, Heather R. Millard, Michael A. Pulsipher, Hisham Abdel-Azim, Jeffery J. Auletta, Valerie Brown, Ka Wah Chan, Miguel Angel Diaz, Andrew Dietz, Marta González Vincent, Gregory Guilcher, Gregory A. Hale, Robert J. Hayashi, Amy Keating, Parinda Mehta, Kasiani Myers, Kristin Page, Tim Prestidge, Nirali N. ShahAngela R. Smith, Ann Woolfrey, Elizabeth Thiel, Stella M. Davies, Mary Eapen

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1523-1530
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number9
DOIs
StatePublished - Sep 2017

All Science Journal Classification (ASJC) codes

  • Hematology
  • Transplantation

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