Cml Treated With Allogeneic Hsct

The prognosis for patients initially treated with HSCT is generally favorable (see Chapter 37). However, certain clinical features do predict for improved survival after HSCT. The European Group for Blood and Marrow Transplantation (EGBMT) registry analyzed data in 3142 patients treated for CML between 1989 and 1997.31 They developed a prognostic risk score based on known risk factors for outcome after HSCT such as age, donor/recipient gender, donor/recipient histocompatibility, stage of disease, and time from diagnosis to transplant. The scoring system that came of this analysis is given in Table 20.2. The total score derived from this system not only predicts transplant-related mortality, but also 5-year leukemia-free survival as depicted in Table 20.3.

Stem cell transplantation, however, is not a static field. Techniques are continually improving, as are reported results. Indeed, in a recent report of a singleinstitution experience of HLA identical sibling allo-geneic HSCT, the reported 3-year disease-free survival

Table 20.2 The EGBMT prognostic scoring system for patients with CML treated with HSCT

Risk factor

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