The following is a summary of “Validation of the transplant conditioning intensity (TCI) index for allogeneic hematopoietic cell transplantation,” published in the November 2023 issue of Oncology by Spyridonidis et al.
The intensity of the conditioning regimen preceding allogeneic hematopoietic cell transplantation (allo-HCT) exhibits significant variability. This study aimed to validate the efficacy of the newly devised transplant conditioning intensity (TCI) score in stratifying preparative regimens for allo-HCT.
Analyzing a distinct patient cohort of 4,060 transplant recipients diagnosed with acute myeloid leukemia who met the inclusion criteria of the original study (underwent allo-HCT in first complete remission with a matched donor), their study focused on a more recent period (2018–2021) and an older age bracket (55–75 years, median 63.4 years). These patients were classified into TCI categories based on calculated TCI scores (low: n = 1934, 48%; intermediate: n = 1948, 48%; high: n = 178, 4%), stratified as [1–2], [2.5–3.5], [4–6], respectively.
The researchers investigated the TCI category’s validity in predicting early non-relapse mortality (NRM), 2-year NRM, and relapse (REL). Unadjusted comparisons revealed significant risk stratification for d100 and d180 NRM, NRM, and REL risk based on the TCI index. Furthermore, in multivariate analysis adjusted for significant variables, the TCI showed an independent association with early NRM, NRM, and REL. Their findings confirm that the TCI accurately reflects conditioning regimen-related morbidity and anti-leukemic efficacy in contemporarily treated patients. This validation holds consistent across various established prognostic factors, reinforcing the TCI’s utility as a valuable tool for risk assessment in allo-HCT.