The aim of this study was to develop a predictive score for moderate-severe chronic graft-versus-host disease (cGVHD) on day +100 after allogeneic stem cell transplantation (HSCT). We studied 1292 patients allografted between 1990 and 2016, alive on day +100 after transplant, without cGVHD, and with full biochemistry laboratory values available. Patients were randomly assigned to a training and a validation cohort (ratio 1:1). In the training cohort, a multivariate analysis identified 4 independent predictors of moderate-severe cGVHD: gamma-glutamyl transferase >= 75 UI/l, creatinine >= 1 mg/dl, cholinesterase <= 4576 UI/l, and albumin <= 4 g/dl. A score of 1 was assigned to each variable, producing a low (0 to 1), intermediate (2 to 3), and high (4) score. The cumulative incidence of moderate-severe cGVHD was 12%, 20%, and 52% (P<.0001) in the training cohort, and 13%, 24%, and 33% (P = .002) in the validation cohort, respectively. The 5-year cumulative incidence of transplant-related mortality (TRM) was 5%, 14%, 27% (P<.0001) and 5%, 16%, 31% (P<.0001), respectively. The 5-year survival was 64%, 57%, 54% (P = .009) and 70%, 59%, 42% (P = .0008) in the 2 cohorts, respectively. In conclusion, Day100 score predicts cGVHD, TRM, and survival and, if validated in a separate group of patients, could be considered for trials of preemptive therapy.

Metafuni, E., Cavattoni, I. M., Lamparelli, T., Raiola, A. M., Ghiso, A., Galaverna, F., Gualandi, F., Di Grazia, C., Dominietto, A., Varaldo, R., Signori, A., Chiusolo, P., Sora', F., Giammarco, S., Laurenti, L., Sica, S., Angelucci, E., Bacigalupo, A., The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation, <<BLOOD ADVANCES>>, 2022; 6 (7): 2309-2318. [doi:10.1182/bloodadvances.2021005675] [https://hdl.handle.net/10807/235491]

The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation

Metafuni, Elisabetta;Chiusolo, Patrizia;Sora', Federica;Laurenti, Luca;Bacigalupo, Andrea
2022

Abstract

The aim of this study was to develop a predictive score for moderate-severe chronic graft-versus-host disease (cGVHD) on day +100 after allogeneic stem cell transplantation (HSCT). We studied 1292 patients allografted between 1990 and 2016, alive on day +100 after transplant, without cGVHD, and with full biochemistry laboratory values available. Patients were randomly assigned to a training and a validation cohort (ratio 1:1). In the training cohort, a multivariate analysis identified 4 independent predictors of moderate-severe cGVHD: gamma-glutamyl transferase >= 75 UI/l, creatinine >= 1 mg/dl, cholinesterase <= 4576 UI/l, and albumin <= 4 g/dl. A score of 1 was assigned to each variable, producing a low (0 to 1), intermediate (2 to 3), and high (4) score. The cumulative incidence of moderate-severe cGVHD was 12%, 20%, and 52% (P<.0001) in the training cohort, and 13%, 24%, and 33% (P = .002) in the validation cohort, respectively. The 5-year cumulative incidence of transplant-related mortality (TRM) was 5%, 14%, 27% (P<.0001) and 5%, 16%, 31% (P<.0001), respectively. The 5-year survival was 64%, 57%, 54% (P = .009) and 70%, 59%, 42% (P = .0008) in the 2 cohorts, respectively. In conclusion, Day100 score predicts cGVHD, TRM, and survival and, if validated in a separate group of patients, could be considered for trials of preemptive therapy.
2022
Inglese
Metafuni, E., Cavattoni, I. M., Lamparelli, T., Raiola, A. M., Ghiso, A., Galaverna, F., Gualandi, F., Di Grazia, C., Dominietto, A., Varaldo, R., Signori, A., Chiusolo, P., Sora', F., Giammarco, S., Laurenti, L., Sica, S., Angelucci, E., Bacigalupo, A., The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation, <<BLOOD ADVANCES>>, 2022; 6 (7): 2309-2318. [doi:10.1182/bloodadvances.2021005675] [https://hdl.handle.net/10807/235491]
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