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Harada, Kaito; Kimura, Shun-Ichi; Fuji, Shigeo; Najima, Yuho; Yakushijin, Kimikazu; Uchida, Naoyuki; Onizuka, Makoto; Ikegame, Kazuhiro; Yano, Shingo; Shingai, Naoki; Matsuoka, Ken-Ichi; Onishi, Yasushi; Sawa, Masashi; Takada, Satoru; Kawakita, Toshiro; Fukuda, Takahiro; Kanda, Junya; Atsuta, Yoshiko; Nakasone, Hideaki
Bone marrow transplantation (Basingstoke), 09/2021, Volume: 56, Issue: 9Journal Article
Although graft failure (GF) is a fatal complication after allogeneic stem cell transplantation (SCT), no mortality risk assessments after salvage SCT have been reported. We developed a comprehensive prognostic scoring system consisting of patient and comorbidity factors with 470 patients as a training cohort out of 940; these patients underwent salvage SCT for GF. The multivariate analysis demonstrated that older age, poorer performance status, a continuation of antimicrobial treatment, and severe organ dysfunction were independently associated with worse overall survival (OS) and non-relapse mortality (NRM). Based on each factor's hazard ratio, weighted scores of 1-3 were assigned to these factors. Using the summed scores (0-8), a prognostic scoring system successfully stratified outcomes after salvage SCT in the cohort. For patients in the low (0-2, n = 122), intermediate (3-4, n = 209), and high score (5-8, n = 110) groups, the 1-year OS was 62.8%, 40.8%, and 14.2%, respectively (P < 0.001), whereas the 1-year NRM was 24.1%, 43.9%, and 72.7%, respectively (P < 0.001). The prognostic value of the scoring system was confirmed in the validation cohort (n = 470). Our scoring system is useful for predicting survival after salvage SCT.
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