Introduction

PAM score is a simple tool for predicting mortality risk in patients undergoing allogeneic bone marrow transplantation. Originally developed and validated at Fred Hutchinson Cancer Research Center, Seattle, this has recently been validated in 276 patients from Japan. We retrospectively evaluated this in our cohort of T deplete myeloablative allogeneic transplants as there are no published studies validating PAM score in T deplete myeloablative setting.

Results

After a median follow up of 63 months 51% of the patients are alive. The predicted mortality for category 2, 3 and 4 patients via PAM score was 28%, 48% and 28% respectively. This was concordant with the predicted mortality at 2yrs for category 2 and 3. Category 4 was not concordant (Chi-square test, P=0.0035).

CharacteristicsN=51 
Age-yr     
      Median 35   
      Range 17-57   
Sex-No (%)     
      Male 29 (57)   
      Female 22 (43)   
Donor type-No (%)     
      Related 29 (57)   
      Unrelated 22 (43)   
Disease type-No (%)     
      ALL 12 (24)   
      AML 24 (48)   
      CML 3   (6)   
      MDS 4   (7)   
      Others 8   (15)   
Disease risk category-No (%)     
      Low 3   (6)   
      Intermediate 32 (63)   
      High 16 (31)   
Conditioning Regimen-No (%)     
      TBI >12Gy 43 (84)   
      TBI<12 3   (6)   
      Non TBI 5   (10)   
Alemtuzumab dose in stem cell bag (mg)     
      0 4   
      7.5 6   
      10 18   
      15 4   
      20 19   
PAM score categories (2 yr probability of mortality)   Predicted(%) Observed(%) 
1 1 <25 0 
2 14 25-50 28 
3 29 50-75 48 
4 7 >75 28 
Follow up (months)     
      Median 63   
      Range 1-162   
CharacteristicsN=51 
Age-yr     
      Median 35   
      Range 17-57   
Sex-No (%)     
      Male 29 (57)   
      Female 22 (43)   
Donor type-No (%)     
      Related 29 (57)   
      Unrelated 22 (43)   
Disease type-No (%)     
      ALL 12 (24)   
      AML 24 (48)   
      CML 3   (6)   
      MDS 4   (7)   
      Others 8   (15)   
Disease risk category-No (%)     
      Low 3   (6)   
      Intermediate 32 (63)   
      High 16 (31)   
Conditioning Regimen-No (%)     
      TBI >12Gy 43 (84)   
      TBI<12 3   (6)   
      Non TBI 5   (10)   
Alemtuzumab dose in stem cell bag (mg)     
      0 4   
      7.5 6   
      10 18   
      15 4   
      20 19   
PAM score categories (2 yr probability of mortality)   Predicted(%) Observed(%) 
1 1 <25 0 
2 14 25-50 28 
3 29 50-75 48 
4 7 >75 28 
Follow up (months)     
      Median 63   
      Range 1-162   
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Figure 1
Figure 1.
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Figure 2
Figure 2.
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Figure 3
Figure 3.
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Disclosures:

Milligan:Celgene: unrestricted educational grant Other.

Topics:
alemtuzumab, bone marrow transplantation, allogeneic, cancer research, donors, follow-up, stem cells, t-lymphocytes, transplantation, conditioning (psychology), disclosure

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2013 by The American Society of Hematology
2013
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