Comparison of Risk Scoring Systems In HLA-Matched Related Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study.

Objective Allogeneic hematopoietic stem cell transplantation (AHSCT) is a potentially curative treatment of choice for many hematological diseases. However, there are some transplantation-related risks. Predicting the risk-benefit ratio prior to AHSCT facilitates the choice of conditioning regimens and post-transplant follow-up. Hence, many risk models have been developed. The aim of the present study was to compare six different risk models clinically used. Material and Methods Hematological malignancies were enrolled in this study. The European Group for Blood and Marrow Transplantation (EBMT), Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI), Age-Adjusted Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI-Age) , revised Pretransplant Assessment of Mortality Score (rPAM), acute leukemia-EBMT score (AL-EBMT) and Disease risk index (DRI) risk models were applied retrospectively. Results AL-EBMT, HCT-CI, HCT-CI-Age, risk scoring systems were found to be predictive for 2-year OS and 2-year NRM (2-year OS; (AL-EBMT: reference vs score 8.5-10 HR:1.3 p:0.035 reference vs score >10 HR: 3.8 p:0.001, HCT-CI: reference vs score 1-2 HR:1.4 p:0.018 reference vs score ≥3 HR:2.5 p 10 HR: 3.3 p: <0.001 HCT-CI: reference vs 1-2 HR:1.3 p:0.028 reference vs score ≥3 HR:2.3 p:0.011 HCT-CI-Age reference vs score 1-2 HR: 1.3 p:0.01 reference vs score ≥3 HR: 2.4 p: 0.003). In terms of Kaplan Meier estimate of 2-year OS and 2-year NRM, the risk scoring systems having the highest predictive power was found to be AL-EBMT (2-year AUC; 0.59-0.60, respectively). The other scores were not found to be predictive for 2-year OS and NRM. Conclusion In the present study at our bone marrow and stem cell transplant center, it has been demonstrated that the HCT-CI, HCT-CI-Age, and AL-EBMT were good predictors of 2-year NRM and OS.