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Post-Transplant Complications

Serial evaluation of the oncological pediatric risk of mortality (O-PRISM) score following allogeneic bone marrow transplantation in children

Bone Marrow Transplantation volume 29, pages 383–389 (2002)Cite this article

Abstract

The O-PRISM score was introduced for risk assessment in children transferred to intensive care following BMT. The aim of this study is to determine the prognostic value of a serial evaluation of the O-PRISM score. Ninety-three children, 58 allogeneic-related and 35 unrelated BMT, were evaluated. At weekly intervals, the O-PRISM was calculated based on the standard PRISM score and the three additional variables CRP, GVHD and hemorrhage. Overall survival was 0.51 ± 0.05 (48/93 patients). Seventeen children died of recurrent disease and 28 of BMT-related complications. High O-PRISM scores significantly correlated with adverse outcome. The relative risks of DOC of patients with scores ⩾10 compared to patients with lower scores were: day 0: 3.9 (95% confidence-interval: 1.1–13.7, P = 0.02), day 7: 2.0 (0.7–6.2, P = 0.20), day 14: 5.2 (1.9–14.0, P = 0.001), day 21: 5.6 (1.9–16.5, P = 0.001), day 28: 11.5 (3.8–100.9, P < 0.001), day 35: 7.3 (1.9–27.7, P = 0.001). As early as day 0, children with scores ⩾10 points showed a higher cumulative incidence of DOC than patients with lower scores (0.69 ± 0.15 vs 0.27 ± 0.05, P = 0.02). The O-PRISM score represents a useful clinical parameter for serial risk assessment following BMT. As it indicates fatal events early, it may be helpful for parent information and even more for the early establishment of intensified supportive treatment. The O-PRISM score may therefore be a valuable parameter for the evaluation of different strategies for BMT and supportive treatment.

Bone Marrow Transplantation (2002) 29, 383–389. doi:10.1038/sj.bmt.1703384

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Acknowledgements

The authors gratefully acknowledge the generous support by Elterninitiative Kinderkrebsklinik e. V. Düsseldorf. The authors wish to thank Monika Schmitz for her assistance with data collection and the nurses of the BMT unit for their expert care of the children. This work is dedicated to Professor Dr P Lemburg, director emeritus of the Pediatric Intensive Care Unit, in acknowledgment for his invaluable support and his long-standing dedication to the most compromised children treated at our institution.

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Authors and Affiliations

  1. Clinic of Pediatric Hematology and Oncology, Heinrich-Heine-University, Medical Center, Düsseldorf, Germany

    DT Schneider, J Cho, HJ Laws, D Dilloo, U Göbel & W Nürnberger

  2. Division of Pediatrics, Clinic for Blood and Marrow Transplantation and Hematology/Oncology, Idar-Oberstein, Germany

    W Nürnberger

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  1. DT Schneider
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Schneider, D., Cho, J., Laws, H. et al. Serial evaluation of the oncological pediatric risk of mortality (O-PRISM) score following allogeneic bone marrow transplantation in children. Bone Marrow Transplant 29, 383–389 (2002). https://doi.org/10.1038/sj.bmt.1703384

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