Utility of a prognostic scoring system for allogeneic stem cell transplantation in patients with chronic myeloid leukemia

Allogeneic stem cell transplantation (SCT) is the treatment of choice for selected patients with chronic myeloid leukemia (CML). However, it is associated with a high risk of treatment-related mortality (TRM) and morbidity. To assist in decision making about transplantation, a simple scoring system to assess the risk is needed. We analyzed the utility of a scoring system, first reported by the European Group for Blood and Marrow Transplantation (EBMT). We analyzed the data from 31 patients who underwent allogeneic transplantation at our institution, using the EBMT scoring system. It was based on five pre-transplant risk factors: donor type, stage of disease at time of transplantation, age of recipient, sex of donor and recipient, and interval between diagnosis and transplant. Seventeen patients had a risk score of 0-2, and 14 patients had a score of 3-7. Using Kaplan-Meier analysis, the estimated 4-year leukemia-free (LFS) and overall survival (OS) for patients with a score of 0-2 were 47 and 53%, respectively. In contrast, the estimated 4-year LFS and OS for patients with a score of 3-7 were 10.5 and 10.5%, respectively. Four-year TRM was 47% for the low-risk group (0-2), and 85% for the high-risk group (3-7). This simple scoring system may play an important role in predicting the outcome of allogeneic SCT, and in choosing the appropriate therapy for patients with CML.