Validation of Different Prognostic Scoring Systems to Assess the Mortality Risk in Children Received Allogeneic Hematopoietic Stem Cell Transplantation in Egypt, a Retrospective Study | ||||
| SECI Oncology Journal | ||||
| Volume 12, Issue 2, April 2024, Page 126-135 | ||||
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| Abstract | ||||
| Background: Despite major advances in the field of hematopoietic stem cell transplantation (HSCT), life-threatening complications still occur. Quantifying the risk of toxicity for individual patients is challenging, but essential for accurate pre-HSCT counseling. Aim: Validate 6 prognostic scoring systems for prediction of mortality risk in pediatrics post allogeneic HSCT [Hematopoietic cell transplantation comorbidity index (HCT-CI), Augmented HCT-CI, European Society for Blood and Marrow Transplantation score (EBMT), Pre-transplantation assessment of mortality score (PAM), disease risk index (DRI) and Endothelial Activation and Stress index (EASIx)]. Methods: We retrospectively analyzed 401 pediatric patients who underwent their first allogeneic HSCT in the period between January 2015 to December 2019. Patients are stratified into different risk groups according to these prognostic indices. We assessed the validation of different risk groups of these systems in predicting OS of the patients. Many patients, transplant-related risk factors and different scoring systems were studied to detect predictors of OS. Results: 3-years Overall survival of benign group was 77%, where in malignant group was 73.2%. HCT-CI (AUC 53% & 61.8% in benign & malignant group respectively) and Augmented HCT-CI (AUC 52.3% in benign and 61.7% in malignant patients) were found to have most sensitive scores to predict 3-year OS in both disease groups. With comparing risk categories of each scoring system, we found that Augmented HCT-CI (P=0.039 & 0.03) in benign & malignant patients respectively) and EASIx (P=0.02 & 0.045 in benign and malignant groups respectively) had a significant power for prediction of 3-year OS in both disease groups where, PAM score (P=0.04) showed significance in benign group and DRI (P=0.023) in malignant group. After adjusting many patients and transplant related factors, Augmented HCT-CI showed the most significant score to predict the mortality risk in pediatrics (P=0.042). Conclusion: Augmented HCT-CI was found to have a strong power to predict mortality risk in pediatric patients post allo-HSCT. Female gender, older age and high ferritin level pre-transplant were associated with increased mortality risk in pediatrics post allo-HSCT. | ||||
| Keywords | ||||
| Allogeneic hematopoietic stem cell transplantation; Prognostic scoring systems; Mortality risk | ||||
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