Early relapse (ER) following Autologous Hematopoietic Cell Transplantation (AHCT) confers a poor prognosis. We therefore developed a novel scoring system to predict ER. A total of 14,367 AHCT-1 patients were transplanted between 2014 and 2019, and were conditioned with Melphalan 200 mg/m2 (Mel200) (n = 7228; 2014-2017) (training cohort); Mel200 (n = 5616; 2018-2019) or Mel140 (n = 1523; 2018-2019) (validation cohorts). PFS-12 and the Cumulative Incidence of Relapse at 12 months were 84.1% and 14.7% (training Mel200), 87.2% and 11.6% (validation Mel200), and 80.3% and 16.9% (validation Mel140), respectively. The points in the risk score were: 0, 1,2 for ISS stages I, II, and III; Disease status: 0 (CR/VGPR); 1 (PR); 2 (SD/MR); 4 (Relapse/Progression); and 1 for Karnofsky ≤ 70. The distribution of scores: 0 (24%), 1 (33.9%), 2 (29.6 %), 3 (9.5%), and ≥4 (2.7%). The score separated PFS-12, with the lowest risk group (n = 1752) having a PFS-12 of 91.7% and the highest risk group (n = 195) 57.1%. This also applied in cytogenetically high-risk patients. If the pre-score baseline risks are 15% (standard risk) and 25% (high-risk), a score of ≥4 confers calculated risks of 38% and 54%, respectively. This novel EBMT ER score, therefore, allows for the identification of five discrete prognostic groups.

Ankara University Ankara Turkey

Asklepios Klinik St Georg Hamburg Germany

Centre Hospitalier Universitaire de Rennes Rennes France

Charles University Prague Czech Republic

CHU Bordeaux Pessac France

CHU de Lille Univ Lille Infinite Lille France

CHU Lapeyronie Montpellier France

CHU Nantes Nantes France

Clinica FOSCAL Floridablanca Santander Colombia

Department of Haematology School of Medicine Trinity College Dublin Dublin Ireland

Erasmus University Medical Center Daniel Den Hoed Rotterdam the Netherlands

European Society for Blood and Marrow Transplantation Leiden Study Unit Leiden the Netherlands

Institute Paoli Calmettes Marseille France

Queen's University Belfast Marseille France

Radboud University Nijmegen Medical Centre Nijmegen the Netherlands

Sheffield Teaching Hospitals NHS Trust Sheffield UK

Universidad Autónoma de Bucaramanga UNAB Bucaramanga Santander Colombia

University College London Hospitals NHS Foundation Trust London UK

University Hospital Brno Brno Czech Republic

University Hospital Duesseldorf Dusseldorf Germany

University Hospital of Bern Bern Switzerland

University Hospital Southampton NHS Foundation Trust Southampton UK

University Medical Center Freiburg Freiburg Germany

University of Heidelberg Heidelberg Germany

University of Rome Tor Vergata Rome Italy

Vilnius University Hospital Santariskiu Clinics Vilnius Lithuania

VU University Medical Center Amsterdam the Netherlands

Bone Marrow Transplant. 2023 Sep;58(9):1065. doi: 10.1038/s41409-023-02014-3. PubMed

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