WHO classification and WPSS predict posttransplantation outcome in patients with myelodysplastic syndrome:: a study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO)

被引：156

作者：

Alessandrino, Emilio Paolo ^{[1
]}

Della Porta, Matteo Giovanni ^{[1
]}

Bacigalupo, Andrea ^{[2
]}

Van Lint, Maria Teresa ^{[2
]}

Falda, Michele ^{[3
]}

Onida, Francesco ^{[4
]}

Bernardi, Massimo ^{[5
]}

Iori, Anna Paola ^{[6
]}

Rambaldi, Alessandro ^{[7
]}

Cerretti, Raffaella ^{[8
]}

Marenco, Paola ^{[9
]}

Pioltelli, Pietro ^{[10
,11
]}

Malcovati, Luca ^{[1
]}

Pascutto, Cristiana ^{[1
]}

Oneto, Rosi ^{[2
]}

Fanin, Renato ^{[12
]}

Bosi, Alberto ^{[13
]}

Levis, A. ^{[14
]}

Rambaldi, A. ^{[15
]}

Bandini, G. ^{[16
]}

Casini, M. ^{[17
]}

Rossi, G. ^{[18
]}

Angelucci, E. ^{[19
,20
]}

Baronciani, D. ^{[19
,20
]}

La Nasa, G. ^{[21
]}

Milone, G. ^{[22
]}

Mordini, N. ^{[23
]}

Guidi, S. ^{[24
]}

Bosi, A. ^{[24
]}

Bacigalupo, A. ^{[25
]}

Van Lint, M. T. ^{[25
]}

Corradini, P. ^{[26
]}

Milani, R. ^{[26
]}

Morra, E. ^{[27
]}

Marenco, P. ^{[27
]}

Deliliers, G. Lambretenghi ^{[28
]}

Onida, F. ^{[28
]}

Ciceri, F. ^{[29
]}

Bernardi, M. ^{[29
]}

Castagna, L. ^{[30
]}

Narni, F. ^{[31
]}

Pioltelli, P. ^{[32
,33
]}

Selleri, Carmine ^{[34
]}

Scime, R. ^{[35
,36
]}

Iannitto, E. ^{[37
]}

Musso, M. ^{[38
]}

Alessandrino, E. P. ^{[39
]}

Locatelli, F. ^{[40
]}

Martelli, F. ^{[41
]}

Visani, G. ^{[42
]}

机构：

[1] Univ Pavia, IRCCS, Fdn Policlin San Matteo, Div Hematol, Piazzale Camillo Golgi 2, I-27100 Pavia, Italy

[2] Osped San Martino Genova, Div Hematol, Genoa, Italy

[3] Osped San Giovanni Battista Torino, Div Hematol, Turin, Italy

[4] Osped Maggiore Policlin, Fdn IRCCS, Dept Hematol, Milan, Italy

[5] Ist Sci San Raffaele, Hematol & Bone Marrow Transplantat Unit, I-20132 Milan, Italy

[6] Univ Roma La Sapienza, Dept Cellular Biotechnol & Hematol, Div Hematol, Rome, Italy

[7] Osped Riuniti Bergamo, Div Hematol, I-24100 Bergamo, Italy

[8] Univ Roma Tor Vergata, Hematol Oncol Transplant Unit, Rome, Italy

[9] Osped Niguarda Ca Granda, Dept Hematol, Milan, Italy

[10] Univ Milano Bicocca, Osped San Gerardo, Div Hematol, Monza, Italy

[11] Univ Milano Bicocca, Osped San Gerardo, Transplant Unit, Monza, Italy

[12] Univ Udine, Div Hematol & Bone Marrow Transplantat, I-33100 Udine, Italy

[13] Univ Florence, Dept Hematol, Florence, Italy

[14] Osped SS Antonio & Biagio, Div Hematol, Alessandria, Italy

[15] Osped Riuniti Bergamo, Div Hematol, I-24100 Bergamo, Italy

[16] Univ Bologna, Osped S Orsola Malpighi, Inst Hematol & Clin Oncol LA Seragnoli, Bologna, Italy

[17] Osped Reg, Dept Hematol, Bolzano, Italy

[18] Spedali Civil Brescia, Div Hematol, I-25125 Brescia, Italy

[19] Osped Oncol A Businco, Div Hematol, Cagliari, Italy

[20] Osped Oncol A Businco, Bone Marrow Transplant Ctr, Cagliari, Italy

[21] Univ Cagliari, Osped R Binagli, Bone Marrow Transplantat Unit, Cagliari, Italy

[22] Osped Ferrarotto, Div Hematol & Bone Marrow Transplantat, Catania, Italy

[23] Osped S Croce & Carlo, Div Hematol, Cuneo, Italy

[24] Univ Florence, Osped Careggi, Dept Hematol, Florence, Italy

[25] Osped San Martino Genova, Div Hematol, Genoa, Italy

[26] Univ Milan, Ist Nazl Tumori, Hematol Bone Marrow Transplantat Unit, Milan, Italy

[27] Osped C Granda Niguarda, Div Hematol, Milan, Italy

[28] Fdn IRCCS Osped Maggiore Policlin, Mangiagalli & Regina Elena, Dept Hematol, Milan, Italy

[29] Ist Sci San Raffaele, Hematol & Bone Marrow Transplantat Unit, I-20132 Milan, Italy

[30] IRCCS Clin Humanitas, Transplantat Unit, Dept Oncol Hematol, Rozzano, Italy

[31] Univ Modena & Reggio Emilia, Dept Hematol & Oncol, Modena, Italy

[32] Univ Milano Bicocca, Osped S Gerardo, Div Hematol, Monza, Italy

[33] Univ Milano Bicocca, Osped S Gerardo, Transplant Unit, Monza, Italy

[34] Univ Naples Federico II, Sch Med, Div Hematol, Naples, Italy

[35] Osped V Cervello, Div Hematol, Palermo, Italy

[36] Osped V Cervello, Transplant Unit, Palermo, Italy

[37] Univ Palermo, Div Hematol, Palermo, Italy

[38] Osped La Maddalena, Dept Oncol, Hematol Unit, Palermo, Italy

[39] Univ Pavia, Div Hematol, Fdn IRCCS Policlin S Matteo, Via Palestro 3, I-27100 Pavia, Italy

[40] Univ Pavia, Pediatr Hematol Oncol, Fdn IRCCS Policlin S Matteo, Via Palestro 3, I-27100 Pavia, Italy

[41] Univ Perugia, Policlin Monteluce, Dept Hematol, I-06100 Perugia, Italy

[42] Osped S Salvatore, Hematol & Transplant Ctr, Pesaro, Italy

[43] Osped Civile, Dept Hematol, Pescara, Italy

[44] Osped Guglielmo Saliceto, Dept Hematol & Oncol, Piacenza, Italy

[45] Univ Pisa, Div Hematol, Pisa, Italy

[46] Osped Bianchi Melacrino Morelli, Transplant Unit A Neri, Reggio Di Calabria, Italy

[47] Arcispedale S Maria Nuova, Hematol Unit, Reggio Emilia, Italy

[48] Univ Roma La Sapienza, Div Hematol, Dept Cellular Biotechnol & Hematol, I-00185 Rome, Italy

[49] Osped S Camillo Roma, Hematol & Stem Cell Transplantat Unit, Rome, Italy

[50] Univ S Cuore, Hematol, Rome, Italy

来源：

BLOOD | 2008年 / 112卷 / 03期

关键词：

D O I：

10.1182/blood-2008-03-143735

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

We evaluated the impact of World Health Organization (WHO) classification and WHO classification-based Prognostic Scoring System (WPSS) on the outcome of patients with myelodysplastic syndrome (MDS) who underwent allogeneic stem cell transplantation (allo-SCT) between 1990 and 2006. Five-year overall survival (OS) was 80% in refractory anemias, 57% in refractory cytopenias, 51% in refractory anemia with excess blasts 1 (RAEB-1), 28% in RAEB-2, and 25% in acute leukemia from MDS (P =.001). Five-year probability of relapse was 9%, 22%, 24%a, 56%, and 53%, respectively (P <.001). Five-year transplant-related mortality (TRM) was 14%,39%,38%,34%, and 44%, respectively (P =.24). In multivariate analysis, WHO classification showed a significant effect on OS (P =.017) and probability of relapse (P =.01); transfusion dependency was associated with a reduced OS (P=.01) and increased TRM (P =.037), whereas WPSS showed a prognostic significance on both OS (P =.001) and probability of relapse (P <.001). In patients without excess blasts, multilineage dysplasia and transfusion dependency affected OS (P =.001 and P =.009, respectively), and were associated with an increased TRM (P =.013 and P =.031, respectively). In these patients, WPSS identified 2 groups with different OS and TRM. These data suggest that WHO classification and WPSS have a relevant prognostic value in posttransplantation outcome of MDS patients.

引用

页码：895 / 902

页数：8

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