Evaluation of Disease Risk Comorbidity Index after Allogeneic Stem Cell Transplantation in a Cohort with Patients Undergoing Transplantation with In Vitro Partially T Cell Depleted Grafts

Article Article scientifique Article Evaluation of Disease Risk Comorbidity Index after Allogeneic Stem Cell Transplantation in a Cohort with Patients Undergoing Transplantation with In Vitro Partially T Cell Depleted Grafts eng 2020 author Beauverd Yan 515148 author Morin Sarah 935831 author Nabergoj Mitja author Stephan Caroline 515584 author Ortiz Carmen De Ramon author Mamez Anne-Claire 918000 author Mahne Elif author Petropoulou Anna 931397 author Giannotti Federica 918560 author Ayer Christian 559379 author Bruno Benjamin author Bounaix Laura 931518 author Anastasiou Maria 894640 author Mappoura Maria 863815 author Tran Thien-An 596381 author Masouridi Levrat Stavroula 844685 author Chalandon Yves 644957 10.1016/j.bbmt.2020.09.022 32980547 1083-8791 https://www.sciencedirect.com/science/article/pii/S1083879120306169 Outcomes of hematopoietic stem cell transplantation (HSCT) are influenced by comorbidities, disease type, and status at transplantation. Several prognostic scores can be used, such as the disease risk index (DRI) or the hematopoietic cell transplantation-specific comorbidity index (HCT-CI). Recently, a new prognostic tool, the disease risk comorbidity index (DRCI), combining the DRI and the HCT-CI, was published. The DRCI determines 6 patient groups (very low risk [VLR], low risk [LR], intermediate risk 1 [IR-1], intermediate risk 2 [IR-2], high risk [HR], and very high risk [VHR]) with a significant predictive value for overall survival (OS), disease-free survival (DFS), relapse incidence (RI), and graft-versus-host disease-free/relapse-free survival (GRFS). However, the DRCI has not been evaluated for patients allografted with partially in vitro T cell depleted (pTDEP) grafts. In our center, we offer pTDEP to reduce graft-versus-host disease for patients in complete remission at transplant time. In this retrospective study, we investigated the DRCI in 404 adult patients (including 37.6% pTDEP) undergoing a first HSCT for hematological malignancies from 2008 to 2018. Because of the small number of patients in LR, VLR and LR were combined for analysis. In the entire cohort, 2-year OS was 84.4% (95% CI, 71.6% to 97.2%) for LR, 61.6% (54.8% to 68.4%) for IR-1, 45.7% (33.3% to 58.1%) for IR-2, 31% (19.4% to 42.6%) for HR, and 30.9% (14.5% to 47.3%) for VHR (P < .001). In addition, the DRCI was predictive of DFS, RI, and GRFS but not of nonrelapsed mortality and graft-versus-host disease. Our study confirms similar results with the original publication but gives less accurate prognosis information than the DRI and HCT-CI when used separately. In conclusion, the DRCI does not seem to offer more relevant information than the DRI and HCT-CI to help physicians and patients for the HSCT decision. Dewey 616 56 Département de médecine 221 false 1216 Leucémie et transplantation allogénique de cellules souches hématopoïétiques 982 Biology of Blood and Marrow Transplantation 7c21df8a-6860-476a-95f6-341eeab4fd59 Article (Accepted version) Public 1-s2.0-S1083879120306169-main.pdf 712440 application/pdf CC BY-NC-ND openAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Evaluation of Disease Risk Comorbidity Index after Allogeneic Stem Cell Transplantation in a Cohort with Patients Undergoing Transplantation with In Vitro Partially T Cell Depleted Grafts	Biology of Blood and Marrow Transplantation			2020	340	298

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Petropoulou, Anna