Validação do Escore de Risco do EBMT em 1.084 pacientes portadores de leucemia mielóide crônica submetidos ao transplante alogênico de células precursoras hematopoiéticas no Brasil / Allogeneic hematopoietic stem cell transplantation - EBMT risk score validation in 1084 chronic myeloid leukemia patients transplanted in Brazil

RESUMO

O estudo consistiu de análise retrospectiva de 1084 pacientes transplantados em dez Centros brasileiros, no período de fevereiro de 1983 a março de 2003, sendo o objetivo principal validar o Escore de Risco do EBMT em pacientes portadores de Leucemia Mielóide Crônica submetidos ao Transplante de Células Precursoras Hematopoiéticas. A idade dos pacientes, fase da doença no momento do transplante, tipo de transplante, se aparentado HLA idêntico, não aparentado ou com discrepâncias no HLA, pareamento de sexos entre doador e receptor, intervalo entre a data do diagnóstico e data do transplante são os critérios que constituem o Escore de Risco do EBMT. As pontuações de cada um desses critérios e a sua somatória estratificam os pacientes em Escores de Risco de zero a sete...

ABSTRACT

the score was 2, in 345 (31.8%) it was 3, in 135 (12.5%) itwas 4 and in the remaining 28 cases (2.6%) the score was5 or 6. There were no cases with a score of 7.The overall survival rate was 49.23% at a median of67 months. The disease free survival rate was 50.36%, thetransplant-related death rate was 45.18% and the incidenceof relapse was 24.66%. ...Avaliação AThis study is a retrospective analysis of 1084 patients transplanted in ten Brazilian centers in the period fromFebruary 1983 to March 2003. The main objective was tovalidate the EBMT risk score in chronic myeloid leukemia patients submitted to allogeneic hematopoietic stem celltransplantation.The risk score is based on five variables recipientage, disease stage, donor type [HLA-identical related,matched unrelated or unmatched donor], donor-recipientgender combination, and interval from diagnosis to transplantation. The total of the points allocated to eachof the different criteria stratifies the patients in risk scoregroups of from zero to seven.The mean age of the evaluated patients in this study was 33 years old (from 6 to 58 years), with 647 (59.7%)male and 437 (40.3%) female. At the time of transplantation,898 (82.8%) were in the chronic phase, 146 (13.5%) in theaccelerated phase and 40 (3.7%) in the blastic phase. Onehundred and fifty-one (13.9%) of the patients were under20 years old, 620 (57.2%) between 20 and 40 years old and313 (28.9%) were older than 40. The transplantation wasHLA-identical related in 1025 (94.6%) of the recipients andnon-related in only 59 (5.4%) of the cases. The donorrecipientgender combination was female into male in 283(26.1%) of the transplantations, whilst other combinationsoccurred in 801 (73.9%) cases. The interval from diagnosisto transplantation was less than 12 months in 223 (20.6%)patients and greater than 12 months in 861 (79.4%). In 179(16.6%) patients, the risk score was 0 or 1, in 379 (36.6%).