Day100 Score Predicts Moderate-Severe cGVHD, TRM, and Survival

Metafuni E, Cavattoni IM, Lamparelli T, et al. Day100 Score Predicts Moderate-Severe cGVHD, Transplant Mortality, and Survival After Hematopoietic Cell Transplantation. Blood Advances. 2022; (doi: 10.1182/bloodadvances.2021005675).

A laboratory-derived score taken on day +100 after allogeneic stem cell transplantation (HSCT) predicts moderate-severe chronic graft-versus-host disease (cGvHD), transplant-related mortality (TRM), and survival, according to new research. The study involved 1,292 patients who underwent HSCT between 1990 and 2016, were alive on Day +100 without cGVHD, randomly assigned on a 1:1 basis to training and validation cohorts. Multivariate analysis in the training cohort identified four independent predictive factors of moderate-severe cGvHD: gammaglutamyltransferase ≥75 UI/l, creatinine ≥1 mg/dl, cholinesterase ≤4,576 UI/l, and albumin ≤4 g/dl. Each factor received a score of 1, yielding a low (0-1), intermediate (2-3), and high (4) score. The cumulative incidence (CI) of moderate-severe cGvHD in the training cohort was 12%, 20%, and 52%, respectively, and 13%, 24%, and 33%, respectively in the validation cohort. The training cohort's respective five-year CI of TRM was 5%, 14%, and 27%, compared with 5%, 16%, and 31%, respectively, in the validation cohort. Five-year survival in the training cohort was 64%, 57%, and 54%, respectively, compared with 70%, 59%, and 42%, respectively, in the validation cohort. If validated in a separate patient cohort, the researchers suggest the Day100 score could be an option for trials of preemptive therapy.

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