To address limitations of the currently used reduced-intensity/myeloablative conditioning (RIC/MAC) classification scheme we aimed to develop a tool that can capture more standardized the conditioning intensity of allogeneic hematopoietic cell transplantation (HCT). We assigned intensity weight scores for frequently used conditioning regimen components and used their sum to generate the transplant conditioning intensity (TCI) score. We retrospectively tested the impact of TCI on 8255 adult (45–65 years) acute myeloid leukemia patients who underwent HCT in first complete remission. A Cox model for early nonrelapse mortality (NRM) yielded a 3-group TCI risk scheme (low, intermediate, high) with respective TCI scores of [1–2], [2.5–3.5] and [4–6]. On multivariate modeling, TCI grouping was highly and better predictive for early (day 100 and 180) NRM, 2-year NRM and relapse (REL) as compared with the RIC/MAC classification. Validation was done on 200 bootstrap samples. Moreover, TCI scoring enabled the identification of a distinct subgroup of RIC and MAC conditioning regimens with an intermediate TCI [2.5–3.5] score that had identical outcomes and which are frequently referred as “reduced toxicity conditioning”. TCI scheme provides an improvement of the RIC/MAC classification. We propose TCI as a new tool to define and measure the conditioning regimen intensity.

Redefining and measuring transplant conditioning intensity in current era: a study in acute myeloid leukemia patients / Spyridonidis, A.; Labopin, M.; Savani, B. N.; Niittyvuopio, R.; Blaise, D.; Craddock, C.; Socie, G.; Platzbecker, U.; Beelen, D.; Milpied, N.; Cornelissen, J. J.; Ganser, A.; Huynh, A.; Griskevicius, L.; Giebel, S.; Aljurf, M.; Brissot, E.; Malard, F.; Esteve, J.; Peric, Z.; Baron, F.; Ruggeri, A.; Schmid, C.; Gilleece, M.; Gorin, N. -C.; Lanza, F.; Shouval, R.; Versluis, J.; Bug, G.; Floisand, Y.; Ciceri, F.; Sanz, J.; Bazarbachi, A.; Nagler, A.; Mohty, M.. - In: BONE MARROW TRANSPLANTATION. - ISSN 0268-3369. - 55:6(2020), pp. 1114-1125. [10.1038/s41409-020-0803-y]

Redefining and measuring transplant conditioning intensity in current era: a study in acute myeloid leukemia patients

Ciceri F.;
2020-01-01

Abstract

To address limitations of the currently used reduced-intensity/myeloablative conditioning (RIC/MAC) classification scheme we aimed to develop a tool that can capture more standardized the conditioning intensity of allogeneic hematopoietic cell transplantation (HCT). We assigned intensity weight scores for frequently used conditioning regimen components and used their sum to generate the transplant conditioning intensity (TCI) score. We retrospectively tested the impact of TCI on 8255 adult (45–65 years) acute myeloid leukemia patients who underwent HCT in first complete remission. A Cox model for early nonrelapse mortality (NRM) yielded a 3-group TCI risk scheme (low, intermediate, high) with respective TCI scores of [1–2], [2.5–3.5] and [4–6]. On multivariate modeling, TCI grouping was highly and better predictive for early (day 100 and 180) NRM, 2-year NRM and relapse (REL) as compared with the RIC/MAC classification. Validation was done on 200 bootstrap samples. Moreover, TCI scoring enabled the identification of a distinct subgroup of RIC and MAC conditioning regimens with an intermediate TCI [2.5–3.5] score that had identical outcomes and which are frequently referred as “reduced toxicity conditioning”. TCI scheme provides an improvement of the RIC/MAC classification. We propose TCI as a new tool to define and measure the conditioning regimen intensity.
File in questo prodotto:
File Dimensione Formato  
s41409-020-0803-y.pdf

solo gestori archivio

Tipologia: PDF editoriale (versione pubblicata dall'editore)
Licenza: Copyright dell'editore
Dimensione 1.11 MB
Formato Adobe PDF
1.11 MB Adobe PDF   Visualizza/Apri   Richiedi una copia

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.11768/138379
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 95
  • ???jsp.display-item.citation.isi??? 87
social impact