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Refinement of the Glasgow Prognostic Score as a pre-transplant risk assessment for allogeneic hematopoietic cell transplantation

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Abstract

The Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) is a widely used tool for pre-transplant risk assessment. Allogeneic hematopoietic cell transplantation (HCT) is performed on patients with diverse backgrounds, highlighting the need for other predictors to complement the HCT-CI and support bedside decision-making. There is a strong body of evidence supporting the use of pre-transplant serum ferritin (SF) in risk assessments of allogeneic HCT. We additionally found that the Glasgow Prognostic Score (GPS), which assesses inflammatory biomarkers and predicts survival of patients with solid organ malignancies, is a useful predictive marker for overall survival (OS) and non-relapse mortality (NRM) in allogeneic HCT, independent of HCT-CI and SF. In this study, we refined the GPS by adding pre-transplant SF to improve its prognostic ability and enable better stratification; we call this revised index the HCT-specific revised Glasgow Prognostic Score (HCT-GPS). We observed that the HCT-GPS more accurately predicted NRM and early-term OS than the GPS. Moreover, the HCT-GPS provides an independent prognostic factor adjusted for the HCT-CI and disease status, and stratifies patients into four risk groups by OS and NRM. Thus, the HCT-GPS is a useful index for predicting early-term complications after allogeneic HCT in patients with hematopoietic diseases.

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Acknowledgements

The authors would like to thank the medical staff at each transplantation center.

Author information

Authors and Affiliations

  1. Department of Stem Cell Transplantation, Niigata University Medical and Dental Hospital, 1-754 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan

    Yasuhiko Shibasaki & Masayoshi Masuko

  2. Department of Hematology, Endocrinology and Metabolism, Niigata University Faculty of Medicine, Niigata, Japan

    Yasuhiko Shibasaki, Tatsuya Suwabe, Takayuki Katagiri, Tomoyuki Tanaka, Takashi Ushiki, Kyoko Fuse, Miwako Narita & Hirohito Sone

  3. Department of Hematology, Nagaoka Red Cross Hospital, Nagaoka, Japan

    Naoko Sato, Toshio Yano, Takashi Kuroha, Shigeo Hashimoto & Tatsuo Furukawa

Authors
  1. Yasuhiko Shibasaki
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  2. Tatsuya Suwabe
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  3. Takayuki Katagiri
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  4. Tomoyuki Tanaka
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  5. Takashi Ushiki
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  6. Kyoko Fuse
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  7. Naoko Sato
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  11. Miwako Narita
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  12. Tatsuo Furukawa
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  13. Hirohito Sone
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  14. Masayoshi Masuko
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Contributions

YS performed research, TS, TK, TT, KF, TU, NS, TY, TK, SH, MN, TF, and HS performed data analysis, YS and MM wrote the manuscript.

Corresponding author

Correspondence to Masayoshi Masuko.

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The authors declare no conflict of interest.

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Supplementary material 1 (DOCX 22 KB)

12185_2018_2463_MOESM2_ESM.tif

Supplemental figure 1: Kaplan–Meier estimates of overall survival (a) and non-relapse mortality (b) using the Glasgow Prognostic Score (GPS). 1 year-mortality in each risk-group of the GPS was as follows, OS 0: 70.3%, 1: 50.0%, 2: 15.8% (a), NRM 0: 19.6%, 1: 28.6%, 2: 52.6% (b). (TIF 158 KB)

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Shibasaki, Y., Suwabe, T., Katagiri, T. et al. Refinement of the Glasgow Prognostic Score as a pre-transplant risk assessment for allogeneic hematopoietic cell transplantation. Int J Hematol 108, 282–289 (2018). https://doi.org/10.1007/s12185-018-2463-x

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  • DOI: https://doi.org/10.1007/s12185-018-2463-x

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