@article{Nico Gagelmann_Diderik-Jan Eikema_Matthias Stelljes_Dietrich Beelen_Liesbeth de Wreede_Ghulam Mufti_Nina Simone Knelange_Dietger Niederwieser_Lone S. Friis_Gerhard Ehninger_Arnon Nagler_Ibrahim Yakoub-Agha_Ellen Meijer_Per Ljungman_Johan Maertens_Lothar Kanz_Lucia Lopez-Corral_Arne Brecht_Charles Craddock_Jürgen Finke_Jan J. Cornelissen_Paolo Bernasconi_Patrice Chevallier_Jorge Sierra_Marie Robin_Nicolaus Kröger_2019, place={Pavia, Italy}, title={Optimized EBMT transplant-specific risk score in myelodysplastic syndromes after allogeneic stem-cell transplantation}, volume={104}, url={https://haematologica.org/article/view/8895}, DOI={10.3324/haematol.2018.200808}, abstractNote={The aim of this study was to develop and validate a clinical and transplant-specific prognostic score using data from a large cohort of patients with myelodysplastic syndromes reported to the European Society for Blood and Marrow Transplantation registry. A Cox model was fitted to detect clinical and transplant-related variables prognostic of outcome. Then, cross-validation was performed to evaluate the validity and consistency of the model. Seven independent risk factors for survival were identified: age ≥50 years, matched unrelated donor, Karnofsky Performance Status <90%, very poor cytogenetics or monosomal karyotype, positive cytomegalovirus status of the recipient, blood blasts >1%, and platelet count ≤50 × 10<sup>9</sup>/L prior to transplantation. Incorporating these factors into a four-level risk score yielded hazard ratios for death, with low-risk (score of 0-1) as reference, of 2.02 (95% CI: 1.41-2.90) for the intermediate-risk group (score of 2-3), 3.49 (95% CI: 2.45-4.97) for the high-risk group (score of 4-5), and 5.90 (95% CI: 4.01-8.67) for the very high-risk group (score of >5). The score was predictive of survival, relapse-free survival, relapse, and non-relapse mortality (<em>P</em><0.001, respectively). Cross-validation yielded significant and reproducible improvement in prognostic ability with C-statistics being 0.609 (95% CI: 0.588-0.629) <em>versus</em> 0.555 for the <em>Gruppo Italiano Trapianto di Midollo Osseo</em&gt; registry and 0.579 for the Center for Blood and Marrow Transplant Research registry. Prediction was even further augmented after applying a nomogram using age and platelets as continuous variables showing C-statistics of 0.628 (95% CI: 0.616-0.637). In conclusion, compared to existing prognostic systems, this proposed transplant-specific risk score offers improved performance with respect to post-transplant risk stratification in myelodysplastic syndromes.}, number={5}, journal={Haematologica}, author={Nico Gagelmann and Diderik-Jan Eikema and Matthias Stelljes and Dietrich Beelen and Liesbeth de Wreede and Ghulam Mufti and Nina Simone Knelange and Dietger Niederwieser and Lone S. Friis and Gerhard Ehninger and Arnon Nagler and Ibrahim Yakoub-Agha and Ellen Meijer and Per Ljungman and Johan Maertens and Lothar Kanz and Lucia Lopez-Corral and Arne Brecht and Charles Craddock and Jürgen Finke and Jan J. Cornelissen and Paolo Bernasconi and Patrice Chevallier and Jorge Sierra and Marie Robin and Nicolaus Kröger}, year={2019}, month={Apr.}, pages={929-936} }