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The post-transplant scoring system (PTSS) is associated with outcomes in patients with MDS after CD34+selected allogeneic stem cell transplant

Bone Marrow Transplantation volume 56, pages 2749–2754 (2021)Cite this article

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Abstract

The post-transplant scoring system (PTSS), developed by the Francophone Society of Bone Marrow Transplantation and Cellular Therapy, is based on three independent post-transplant risk factors: grade of acute graft-versus-host disease, lack of platelet recovery before day 100, and relapse before day 100; discriminating low- (0), intermediate- (1–3), and high-risk (4–8) patients. We investigated the prognostic value of the PTSS in a cohort of patients with MDS who underwent myeloablative CD34-selected TCD transplants. From 2008 to 2018, 109 patients underwent a first TCD-HCT for MDS at our center. We used Cox proportional hazards models and different landmark analyses to evaluate the association of categorized PTSS score risk groups with overall survival (OS). Patients with an intermediate/ high risk PTSS score had decreased OS at day 180 (univariate HR 3.25 [95% CI 1.60, 6.60], p = 0.001) and at day 365 (univariate HR 5.42 [95% CI 2.21, 13.3], p < 0.001) compared to low risk PTSS scores. This association remained significant after adjusting for HCT-CI. PTSS score calculated at day 100 was not associated with OS, even after adjusting for HCT-CI subgroups. In summary, the PTSS predicted survival at day 180 and day 365 in recipients of T-cell-depleted allografts for myelodysplastic syndrome.

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Fig. 1: Transplant outcomes in patients with MDS.
Fig. 2
Fig. 3: Overall survival in patients with MDS based on PTSS subgroups.

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Funding

This research was supported in part by National Institutes of Health award number P01 CA23766 and NIH/NCI Cancer Center Support Grant P30CA008748. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. AAT is supported by a grant from the Alfonso Martin Escudero Foundation.

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Authors and Affiliations

  1. Adult Bone Marrow Transplant Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Ana Alarcon Tomas, Molly Maloy, Josel D. Ruiz, Nerea Castillo, Martina Pennisi, Christina Cho, Brian Shaffer, Hugo Castro-Malaspina, Sergio A. Giralt, Roni Tamari & Miguel-Angel Perales

  2. Department of Biostatistics and Epidemiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Karissa Whiting & Sean Devlin

  3. Department of Hematology, University Hospital Marqués de Valdecilla, Santander, Spain

    Miriam Sanchez-Escamilla & Lucrecia Yañez

  4. Department of Hematological Malignancies and Stem Cell Transplantation, Research Institute of Marques de Valdecilla (IDIVAL), Santander, Spain

    Miriam Sanchez-Escamilla & Lucrecia Yañez

  5. Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy

    Martina Pennisi

  6. Department of Medicine, Weill Cornell Medical College, New York, NY, USA

    Christina Cho, Brian Shaffer, Hugo Castro-Malaspina, Virginia Klimek, Sergio A. Giralt, Roni Tamari & Miguel-Angel Perales

  7. Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Virginia Klimek

Authors
  1. Ana Alarcon Tomas
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  2. Karissa Whiting
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  3. Molly Maloy
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  4. Josel D. Ruiz
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  5. Sean Devlin
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  10. Christina Cho
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  11. Brian Shaffer
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  12. Hugo Castro-Malaspina
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  16. Miguel-Angel Perales
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Contributions

AAT and M-AP designed the study. AAT, MM, JDR, MS-E, LY, and NC collected data. KW, SD, AAT, and M-AP analyzed and interpreted data. All authors participated in writing the manuscript, and all approved the final manuscript.

Corresponding author

Correspondence to Miguel-Angel Perales.

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Competing interests

SAG has served as a consultant for Amgen, Actinium, Celgene, Johnson & Johnson, Jazz Pharmaceutical, Takeda, Novartis, Kite, and Spectrum Pharma and has received research funding from Amgen, Actinium, Celgene, Johnson & Johnson, Miltenyi, and Takeda. M-AP has received honoraria from Abbvie, Bellicum, Bristol-Myers Squibb, Incyte, Merck, Novartis, Nektar Therapeutics, and Takeda; serves on DSMBs for Servier and Medigene, and the scientific advisory boards of MolMed and NexImmune; and has received research support for clinical trials from Incyte, Kite (Gilead), and Miltenyi Biotec.

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Alarcon Tomas, A., Whiting, K., Maloy, M. et al. The post-transplant scoring system (PTSS) is associated with outcomes in patients with MDS after CD34+selected allogeneic stem cell transplant. Bone Marrow Transplant 56, 2749–2754 (2021). https://doi.org/10.1038/s41409-021-01392-w

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