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

Beauverd, Yan; Morin, Sarah; Nabergoj, Mitja; Stephan, Caroline; Ortiz, Carmen De Ramon; Mamez, Anne-Claire; Mahne, Elif; Petropoulou, Anna; Giannotti, Federica; Ayer, Christian; Bruno, Benjamin; Bounaix, Laura; Anastasiou, Maria; Mappoura, Maria; Tran, Thien-An; Masouridi Levrat, Stavroula; Chalandon, Yves

doi:10.1016/j.bbmt.2020.09.022

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Title		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
Authors		Beauverd, Yan Morin, Sarah Nabergoj, Mitja Stephan, Caroline Ortiz, Carmen De Ramon Mamez, Anne-Claire Mahne, Elif Petropoulou, Anna Giannotti, Federica Ayer, Christian Bruno, Benjamin Bounaix, Laura Anastasiou, Maria Mappoura, Maria Tran, Thien-An Masouridi Levrat, Stavroula Chalandon, Yves show all authors [1 - 17]
Published in		Biology of blood and marrow transplantation. 2020
Abstract		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.
Identifiers		DOI: 10.1016/j.bbmt.2020.09.022 PMID: 32980547
Full text		Article (Accepted version) (696 Kb) - Free access Other version: https://www.sciencedirect.com/science/article/pii/S1083879120306169
Structures		Faculté de médecine / Section de médecine clinique / Département de médecine
Research group		Leucémie et transplantation allogénique de cellules souches hématopoïétiques (982)
Citation (ISO format)		BEAUVERD, Yan et al. 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. In: Biology of Blood and Marrow Transplantation, 2020. doi: 10.1016/j.bbmt.2020.09.022 https://archive-ouverte.unige.ch/unige:143929