Long-standing interest exists in estimating non-relapse mortality (NRM) following allogeneic hematopoietic cell transplantation (HCT) for AML, but existing methods have low discriminative capabilities. The researchers studied the Treatment-Related Mortality (TRM) score, which was originally created to predict early mortality following induction chemotherapy and is now used as a predictor of post-HCT outcome in 861 adults with AML.At 3 years, 9% (5–13%) of patients in the Q1 quartile had an increased NRM risk vs. 28% (22–34%) in the Q4 quartile.The 3-year relapse rate was lower in patients with a lower TRM score (26% [20–32%] vs. 37% [30–43%], Q1 vs. Q4).Consequently, relapse-free survival (RFS) and overall survival (OS) calculated progressively decreased (RFS at 3 years: 66% [59–72%] in Q1 vs. 36% [29–42%] in Q4; OS at 3 years: 72% [66–78%] in Q1 vs. 39% [33–46%] in Q4). The TRM score predicted NRM better than the Pretransplantation Assessment of Mortality (PAM) score (0.603) or the HCT-CI/age composite score (0.576), with a C-statistic of 0.661 (continuous variable) and 0.642 (categorized by quartile).Although the ability to predict post-HCT outcomes remains challenging, the findings suggest that the TRM score might be beneficial for risk stratification in allogeneic HCT patients with AML.
Source:www.nature.com/articles/s41375-022-01574-5
