Impact of risk scores in outcome of patients with myeloid neoplasms after allogeneic stem cell transplant

Fernández-Caballero, Mariana; Lorenzo, Maria-Josefa Jiménez; Fe, Mireia Morgades de la; Coll, Christelle Ferra i; Sabater, Laura Abril; Ferrando, José-Tomás Navarro; Santasusana, Josep-Maria Ribera

doi:10.1016/j.medcli.2021.05.025

Cited by 2 publications

(2 citation statements)

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“…Despite successfully stratifying survival outcomes, the utility of the DRI is weakened by the absence of metrics related to TRM. In a recent study from Spain, Fernandez-Caballero studied a combination of risk scores (HCT-CI and DRI) to predict prognosis in 175 patients ( 50 ). They reported that a combination of DRI 0-1 and HCT-CI 0-2 showed a higher OS compared to DRI 0-1 and HCT greater than or equal to 3 (45% vs 36%; p 0.041) ( 50 ).…”

Section: Role and Considerations For Allogeneic Transplantmentioning

confidence: 99%

“…In a recent study from Spain, Fernandez-Caballero studied a combination of risk scores (HCT-CI and DRI) to predict prognosis in 175 patients ( 50 ). They reported that a combination of DRI 0-1 and HCT-CI 0-2 showed a higher OS compared to DRI 0-1 and HCT greater than or equal to 3 (45% vs 36%; p 0.041) ( 50 ). The combination of these scores might better predict OS based though this needs to be validated in more patients.…”

Section: Role and Considerations For Allogeneic Transplantmentioning

confidence: 99%

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BMT for Myelodysplastic Syndrome: When and Where and How

Jain

Elmariah

2022

Front. Oncol.

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Myelodysplastic syndromes (MDS) are a diverse group of hematological malignancies distinguished by a combination of dysplasia in the bone marrow, cytopenias and the risk of leukemic transformation. The hallmark of MDS is bone marrow failure which occurs due to selective growth of somatically mutated clonal hematopoietic stem cells. Multiple prognostic models have been developed to help predict survival and leukemic transformation, including the international prognostic scoring system (IPSS), revised international prognostic scoring system (IPSS-R), WHO prognostic scoring system (WPSS) and MD Anderson prognostic scoring system (MDAPSS). This risk stratification informs management as low risk (LR)-MDS treatment focuses on improving quality of life and cytopenias, while the treatment of high risk (HR)-MDS focuses on delaying disease progression and improving survival. While therapies such as erythropoiesis stimulating agents (ESAs), erythroid maturation agents (EMAs), immunomodulatory imide drugs (IMIDs), and hypomethylating agents (HMAs) may provide benefit, allogeneic blood or marrow transplant (alloBMT) is the only treatment that can offer cure for MDS. However, this therapy is marred, historically, by high rates of toxicity and transplant related mortality (TRM). Because of this, alloBMT is considered in a minority of MDS patients. With modern techniques, alloBMT has become a suitable option even for patients of advanced age or with significant comorbidities, many of whom who would not have been considered for transplant in prior years. Hence, a formal transplant evaluation to weigh the complex balance of patient and disease related factors and determine the potential benefit of transplant should be considered early in the disease course for most MDS patients. Once alloBMT is recommended, timing is a crucial consideration since delaying transplant can lead to disease progression and development of other comorbidities that may preclude transplant. Despite the success of alloBMT, relapse remains a major barrier to success and novel approaches are necessary to mitigate this risk and improve long term cure rates. This review describes various factors that should be considered when choosing patients with MDS who should pursue transplant, approaches and timing of transplant, and future directions of the field.

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Section: Role and Considerations For Allogeneic Transplantmentioning

confidence: 99%

Section: Role and Considerations For Allogeneic Transplantmentioning

confidence: 99%

BMT for Myelodysplastic Syndrome: When and Where and How

Jain

Elmariah

2022

Front. Oncol.

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Management of adult patients with CMML undergoing allo-HCT: recommendations from the EBMT PH&G Committee

Onida,

Gagelmann,

Chalandon

et al. 2024

Blood

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Chronic myelomonocytic leukemia (CMML) is a heterogeneous disease presenting with either myeloproliferative or myelodysplastic features. Allogeneic hematopoietic cell transplantation (allo-HCT) remains the only potentially curative option, but the inherent toxicity of this procedure makes the decision to proceed to allo-HCT challenging, particularly as patients with CMML are mostly older and comorbid. Therefore, the decision between a non-intensive treatment approach and allo-HCT represents a delicate balance, especially since prospective randomized studies are lacking and retrospective data in the literature is conflicting. International consensus on the selection of patients and the ideal timing of allo-HCT specifically in CMML could not be reached in international recommendations published six years ago. Since then, new, CMML-specific data have been published. The European Society for Blood and Marrow Transplantation (EBMT) Practice Harmonization and Guidelines Committee assembled a panel of experts in the field to provide the first best practice recommendations on the role of allo-HCT specifically in CMML. Recommendations were based on the results of an international survey, a comprehensive review of the literature, and expert opinions on the subject, after structured discussion and circulation of recommendations. Algorithms for patient selection, timing of allo-HCT during the course of the disease, pre-transplant strategies, allo-HCT modality, as well as post-transplant management for patients with CMML were outlined.

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Impact of risk scores in outcome of patients with myeloid neoplasms after allogeneic stem cell transplant

Cited by 2 publications

References 18 publications

BMT for Myelodysplastic Syndrome: When and Where and How

BMT for Myelodysplastic Syndrome: When and Where and How

Management of adult patients with CMML undergoing allo-HCT: recommendations from the EBMT PH&G Committee

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