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

[en] 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. © 2020, The Author(s), under exclusive licence to Springer Nature Limited.

Disciplines :

Hematology

Author, co-author :

Spyridonidis, A.; Department of Internal Medicine, Bone Marrow Transplantation Unit, University Hospital of Patras, Patras, Greece

Labopin, M.; Service d’ Hématologie Clinique et Thérapie Cellulaire, Hospital Saint-Antoine, Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), Paris, France

Savani, B. N.; Long term Transplant Clinic, Vanderbilt University Medical Center, Nashville, TN, United States

Niittyvuopio, R.; HUCH Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki, Finland

Blaise, D.; Centre de Recherche en Cancérologie de Marseille, Institut Paoli Calmettes, Marseille, France

Craddock, C.; University Hospital Birmingham NHS Trust, Birmingham, United Kingdom

Socié, G.; Department of Hematology-BMT, Hospital St. Louis, Paris, France

Platzbecker, U.; Hematology and Cellular Therapy, University Hospital, Leipzig, Germany

Beelen, D.; Department of Bone Marrow Transplantation, West German Cancer Center, University Hospital of Essen, Essen, Germany

Milpied, N.; CHU Bordeaux, Hospital Haut-Leveque, Pessac, France

More authors (24 more)

Language :

English

Title :

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

Publication date :

2020

Journal title :

Bone Marrow Transplantation

ISSN :

0268-3369

eISSN :

1476-5365

Publisher :

Springer Nature

Volume :

Pages :

1114-1125

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 03 September 2020

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