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EBMT 2025 | Developing a new prognostic scoring system for post-alloSCT survival of patients with acute leukemia
Alexandros Spyridonidis, MD, University of Patras, Patras, Greece, comments on the development of a new prognostic scoring system for predicting survival in patients with acute leukemia undergoing allogeneic stem cell transplantation (alloSCT). Prof. Spyridonidis highlights the importance of adopting a holistic approach and combining multiple factors, including patient-related, disease-related, and conditioning intensity scores, to provide more accurate and personalized survival probabilities. This interview took place at the 51st Annual Meeting of the EBMT in Florence, Italy.
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Transcript
As a transplant physician I have to make predictions. I want to offer the safest transplantation for my patient but I know this can end in tragedy. That’s why nowadays we use some specific tools to offer safer transplantation, for example the high CTCI score, which captures the patient factors that may influence outcome, or the DRI score, disease-related index, which captures the disease-related factors that may influence outcome, or the TCI, the Transplant Conditioning Intensity score, which captures the intensity of the conditioning that we’re giving...
As a transplant physician I have to make predictions. I want to offer the safest transplantation for my patient but I know this can end in tragedy. That’s why nowadays we use some specific tools to offer safer transplantation, for example the high CTCI score, which captures the patient factors that may influence outcome, or the DRI score, disease-related index, which captures the disease-related factors that may influence outcome, or the TCI, the Transplant Conditioning Intensity score, which captures the intensity of the conditioning that we’re giving.
But as you see, every score misses something. That’s why we thought in the Acute Leukemia Working Party, we could look in our database, we looked at about 25,000 patients with acute leukemia. And we looked at all these patients and found they have a survival probability of about 56%. But it is not enough if you want to counsel the patient. He wants to know exactly. Doctor, with this condition, what am I going to take with this disease, with this procedure, what are the possibilities that I will be cured with the transplantation?
And that’s why I went back to this database and we made the score, which takes all these available scores that are there, patient-related, disease-related, condition-related, to put them all together in a combined score. And we made this holistic score. And now we can see that if we look in our database, that I can counsel the patient. If we have this score, your probability of cure after transplant is 26%, or 40%, or 55%, or 75%. So we stratified very effectively the patients, and now it’s very important how we counsel our patients.
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