Background: Whether patients with relapsed multiple myeloma (MM) should proceed directly to a second autologous stem cell transplantation (ASCT2) or receive re-induction chemotherapy beforehand remains uncertain. In real-world practice, treatment allocation is highly heterogeneous, and comparative data addressing the impact of pre-ASCT2 strategy on survival outcomes are limited, partly because ASCT2 is reserved for selected patients and is not routinely performed in all relapsed MM cases. We aimed to evaluate real-world outcomes of ASCT2 performed either directly at relapse or following re-induction chemotherapy in patients with relapsed MM, with a focus on progression-free survival after ASCT2 (PFS2) and overall survival (OS). Methods: We conducted a multicenter retrospective cohort study including 42 patients with relapsed MM who underwent ASCT2 between 2012 and 2024 across eight centers. Patients were grouped according to pre-ASCT2 management: those proceeding directly to ASCT2 without additional systemic therapy (direct-ASCT2, n = 21) and those receiving ≥ 1 line of salvage chemotherapy prior to ASCT2 (re-induction, n = 21). Survival outcomes were estimated using Kaplan-Meier methods and explored using multivariable Cox regression analyses. Results: The median PFS2 for the entire cohort was 19.7 months (95% CI, 7.8-31.6), with no statistically significant difference between the direct-ASCT2 and re-induction groups (21.3 vs. 13.8 months; p = 0.790). Median OS was 48.2 months (95% CI, 41.3-55.1). Although OS was significantly longer in the unadjusted analysis (51.7 vs. 39.6 months; p = 0.019), this difference was not maintained after multivariable adjustment. Post-ASCT2 response rates were comparable between groups, and day-100 transplant-related mortality was low at 2.4%. Conclusions: In this multicenter real-world cohort, pre-ASCT2 re-induction chemotherapy was not associated with a clear improvement in PFS2 compared with proceeding directly to ASCT2. Observed differences in unadjusted OS likely reflect confounding by indication and selection bias inherent to retrospective treatment allocation. These findings should therefore be interpreted as hypothesis-generating, but they add to the limited real-world evidence base on ASCT2, a salvage strategy that is typically applied to highly selected patients.

Objective: To determine the independent prognostic influence of pre-treatment anemia severity in patients with acute myeloid leukemia. Patients and Methods: This was a retrospective evaluation of AML patients between January 2002 and May 2018 at a university hospital hematology clinic. The patients were divided into four groups: intensive treatment achieving complete remission (CR), intensive treatment without CR, non-intensive treatment, and supportive treatment. Baseline clinicodemographic features, laboratory data including serum hemoglobin levels, were collected. Baseline and post-treatment hemoglobin levels were compared according to treatment and across groups. A logistic regression analysis was also made to evaluate the influence of anemia on achieving a complete remission. Results: The mean hemoglobin level at the time of diagnosis was 8.5 g/dL (6.4 – 14.4). Although hemoglobin value was lower in the secondary AML subgroup, there was no significant difference between the groups at the time of diagnosis (p = 0.082). Hemoglobin values after induction chemotherapy were significantly different between treatment groups (p <0.001). When the variables predicting complete remission are examined by logistic regression, per 1 gr/dL increase in hemoglobin level at the time of diagnosis increased the probability of remission significantly (p = 0.047, OR = 1.13, 95% CI 1.07 - 1.24). Conclusion: A patient’s baseline pre-treatment serum hemoglobin level can predict the achievement of complete remission in AML patients. Anemia improves with induction chemotherapy, even without complete remission.

The past decade has seen the development of immunotherapy for the treatment of multiple myeloma (MM), beginning with monoclonal antibodies (mAbs) in the relapsed and refractory setting and culminating in the market approval of chimeric antigen receptor T cells (CAR-T) and bispecific antibodies (BsAbs). The medical community is evaluating the efficacy and safety of these targeted immunotherapies, most of which currently target B-cell maturation antigen (BCMA) on the surface of plasma cells. Two anti-BCMA CAR-T products are available for treating relapsed or refractory MM: idecabtagene vicleucel (ide-cel) and ciltacabtagene autoleucel (cilta-cel). Ide-cel and cilta-cel demonstrate the ability to induce deep responses in heavily pretreated diseases, including patients with triple-class-refractory and penta-refractory diseases. However, there are key similarities and differences regarding these agents, unknowns regarding their comparative efficacy and toxicity, and mechanisms underlying resistance to these new immunotherapies. This review discusses CAR-T cell therapy in relapsed refractory MM, with a focus on efficacy, toxicities, and the evolving trajectories of these therapies in the USA, as well as access in Turkey.

To the Editor,Approximately half of all acute myeloid leukemia (AML) patients eventually relapse after allogeneic stem cell transplantation (aHSCT) [1], and the best treatment after aHSCT is unclear.The present study sought to demonstrate the outcomes of the combination of venetoclax and azacitidine (VEN-AZA) in patients with relapsed AML after aHSCT who were unsuitable for intensive regimens.This study had a single-center, retrospective cohort design.The study sample consisted of patients treated at Hacettepe University in Türkiye.Ethical approval was obtained from the local ethics committee with document number GO22/307.Adult patients aged >18 years admitted between January 2018 and December 2021 were screened.The inclusion criteria were receiving aHSCT for the treatment of AML, experiencing AML relapse after aHSCT, and being treated with the VEN-AZA combination.Patients with acute promyelocytic leukemia were excluded.The basic demographic data of the patients, test results, treatments received, disease status, final status, and causes of death were recorded.

Objective: We aimed to delineate the effects of the ABO groups and the main clinical outcomes with the current SARS-CoV-2 variants, i.e., delta and omicron. Materials and Methods: In this retrospective case-control study, the total 360 adult COVID-19 patients who were followed in the pandemic waves of delta and omicron variants and had ABO blood group analysis were included and divided into two groups according to the waves of variant. Demographic characteristics, comorbidities, length of hospitalization and intensive care needs, survival and ABO groups of cases were recorded. These groups were then compared with the ABO group distribution of population-reflecting 1881 healthy individuals and 186 historical alpha variant cases. Results: The demographic characteristics of the case groups and control group were similar. ABO distributions of the delta and omicron wave groups compared to the control group did not show a statistically significant difference. While advanced age (p<0.001) and presence of comorbidity (p=0.006) showed statistically significant differences in terms of overall survival, ABO blood group was not found to be a risk factor for mortality (p=0.114 in delta, and 0.526 in omicron), hospitalization time (p=0.148 in delta, p=0.224 in omicron), and intensive care unit admission (p=0.096 in delta, p=0.229 in omicron). Conclusion: The risk of infection among ABO blood groups, which has been shown in previous studies for the alpha variant against group A and in favor of group O, does not appear to be valid for delta and omicron period patients. Therefore, the anti-infective measures, especially vaccination, should not differ for individuals according to ABO blood group.

Background/aim: Since well-designed prospective comparative trials are lacking, haploidentical hematopoietic stem cell transplantations approach should be based on the expertise of a particular center. In this study, we aimed to report the results and outcomes of patients who underwent haploidentical hematopoietic stem cell transplantation. Materials and methods: Thirty-nine patients who underwent transplantation in our clinic between 2015 and 2022 were retrospectively analyzed. Primary end point of this study is to find out the survival rates of the patients. Results: The overall survival of patients was 29.9 ± 4.9 months. The disease-free survival of the patients was 37.8 ± 5.7 months. The 3-year overall survival rate of the patients was %50 and the 3-year disease-free survival rate of the patients was %53. Nineteen patients were nonsurvivors among a total of 39 patients. Busulfan-fludarabine-thiotepa was the most frequently used conditioning regimen for transplantation. Busulfan-fludarabin-antithymocyte globulin regimen is the second preferred conditioning regimen. Cyclosporine- cyclophosphamide-mycophenolate mofetil was the most widely used graft-versus-host disease prophylaxis regimen. Sixteen patients had graft-versus-host disease, 28% of the patients had acute graft-versus-host disease, and 13% had chronic graft-versus-host disease. Gastrointestinal system consists of the most involved organs in graft-versus-host disease since 15% of the patients had gastrointestinal graft-versus-host disease. First-degree relatives (parent/child) were the most frequent donor source for haploidentical hematopoietic stem cell transplantation. Sepsis was the most frequent reason of death among transplant patients. Conclusion: In our center, we prefer to use high dose posttransplantation cyclophosphamide after haploidentical hematopoietic stem cell transplantation for graft-versus-host disease prophylaxis. With this approach, our center's overall survival and disease-free survival rates are comparable and compatible with the literature findings.

The distinctive clinical course and outcomes of COVID-19 infection in multiple myeloma patients are still not well established. In this study, we aimed to assess the clinical outcomes and associated factors of COVID-19 in patients with multiple myeloma (MM). This is a multi-center retrospective cohort study. Multiple myeloma patients treated in two tertiary centers were investigated, and the patients diagnosed with COVID-19 during follow-up were included. The main characteristics and clinical outcomes of patients were analyzed. A total of thirty patients were included for analysis. In this cohort, autologous hematopoietic stem cell transplantation (AHSCT) was performed in 63.3% of the patients, and 36.7% were in complete remission when COVID-19 was detected. The total fatality rate (FR) was 36%, and the COVID-19-related case fatality rate (CFR) was 30% for MM patients in our cohort. There was two non-COVIDrelated mortality. The CFR was associated with intensive care unit admission (26.7%, p< 0.001), mechanical ventilation (26.6%, p< 0.001), increased lactate dehydrogenase (p= 0.008) and lymphopenia (p= 0.042). Older age (> 65-years), stem cell transplantation, and comorbidities were not effective on the fatality rate. This study shows that the CFR rate was high in MM patients, irrespective of AHSCT status. Therefore, we suggest strict monitoring and adequate vaccination in this group. However, further studies, including vaccination data with a larger group of patients, are needed to clarify the literature.

Our second case is a 49-year-old female patient, two days after receiving BNT162b2 mRNA COVID-19 vaccine, petechiae was started in arms and then in lower extremities. The complaints of weakness and fatigue continued to increase within days. The patient, who was admitted to the hospital ten days later with these complaints, was found to have bi-cytopenia. Bone marrow aspiration and biopsy reported that 20-30% stained with cd19 diffuse positive Terminal deoxynucleotidyl transferase (TdT) in blastic cells. HyperCVAD chemotherapy was started with the diagnosis of b-acute lymphoOur third case is a 57-year-old male patient, difficulty in swallowing, and oral ulceration after vaccination of BNT162b2 mRNA COVID-19 vac

Objective: Chronic myeloid leukemia (CML) prognostication at the time of diagnosis is critical to determine the intensity of initial treatment. Event-free survival (EFS) has become a prominent concept of prognosis in the patients with chronic phase CML (CML-CP). The aim of this study is to assess the prognostic impact of bone marrow (BM) and peripheral blood (PB) cellular components, in correlation with the clinical parameters. Materials and Methods: One hundred forty-three patients with CML-CP on the front-line imatinib mesylate therapy were recruited into this study. Clinical and laboratory characteristics, therapeutic responses were recorded. Sokal, Euro/Hasford, The EUropean Treatment Outcome Study (EUTOS) and The EUTOS long-term survival (ELTS) scores were calculated for the studied patients. Results: Median follow-up time was 84 (IQR: 54-125) and median front-line therapeutic duration was 56 (IQR:23-89) months. Five-year EFS rate was 62.3% (95% CI: 53.9-70.7). The blast percentage in the BM, EUTOS scores, and basophil percentage in PB were related with the poor therapeutic outcomes in frontline therapy (p=0.002, p=0.002 and p=0.042, respectively). Although Sokal risk classification showed that the intermediate class had a higher event risk compared to the low-risk class (p=0.001), the predictive association disappeared in high-risk classes. Conclusion: EUTOS score system has better predictive capability for front-line imatinib therapy comparing with other indices. Higher blast percentage in BM and increased basophil percentage in PB are independent risk factors, adversely related with EFS in patients with CML.

Background/aim Thrombocytopenia is a common complication following hematopoietic stem cell transplantation (HSCT). Eltrombopag has been used in thrombocytopenia treatment after HSCT in recent years. Herein, we present our experience of 25 patients treated with eltrombopag for post-HSCT thrombocytopenia. Materials and methods Fifteen autologous hematopoietic stem cell transplantation (AHSCT) and 10 allogenic hematopoietic stem cell transplantation (allo-HSCT) recipients treated with eltrombopag for treatment of prolonged isolated thrombocytopenia (PIT) or secondary failure of platelet recovery (SFPR) in the stem cell transplantation unit of Hacettepe University Hematology Department between 2017 and 2021 were included in the study. The primary endpoint of this study is eltrombopag response in patients diagnosed with PIT or SFPR. Platelet count above 50,000/mm3 for five consecutive days without platelet transfusion was considered as eltrombopag response. Overall survival (OS) analyses were calculated based on the time between HSCT and death from any cause. The patients who were alive at the last follow-up were censored at this time for calculation of OS analyses. Results AHSCT (66.7% (10/15)) and allo-HSCT (50% (5/10)) recipients responded to eltrombopag for the treatment of post-HSCT thrombocytopenia. There was no excess toxicity related to the eltrombopag use. The median response duration of allo-HSCT recipients and AHSCT recipients were 41 (13–104) days and 50 (7–342) days, respectively. There was a statistically significant OS duration difference between the responders and nonresponders in allo-HSCT and AHSCT recipients with p values of 0.005 and 0.02, respectively. Conclusion Eltrombopag is promising for the treatment of thrombocytopenia after AHSCT and allo-HSCT in terms of efficacy and safety.

Introduction Severe aplastic anemia (SAA) is a life-threatening disorder and may be associated with significant morbidity and mortality. The first treatment option is allogeneic hematopoietic stem cell transplant (allo-HSCT) for fit patients who have human leukocyte antigen (HLA) identical siblings. Bone marrow is recommended as stem cell source due to less graft versus host disease (GvHD) risk but recently peripheral blood stem cell (PBCS) transplantation has been performed in more centers. Objective There are a few study comparing the BM and PBSC source for SAA in the literature. We sought to assess the rates of acute GvHD (aGvHD) and chronic GvHD (cGvHD) to determine the safety of PBSC for transplantation of severe aplastic anemia. Methods Comprehensive literature search was conducted on PubMed, Cochrane, and Web of Science using MeSH terms and keywords for " Aplastic Anemia" AND " Stem Cell Transplantation" in July 2022 by following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We applied the time constrain between 2000-2022. Our search produced a total of 2106 records After screening and removing irrelevant and review articles, we included 4 original articles comparing transplantation with PBSC and BM sources and contained results of aGVHD grade 2-4; aGvHD grade 3-4 and cGVHD. Statistical analyses were performed with Comprehensive meta-analysis version 3. Heterogeneity was assessed using the I-squared measure. Results A total of 4 studies (5633 patients; 1438 and 4195 patients PBSC and BM respectively) were included in the analysis. All patients were underwent Allo-HSCT with HLA identical siblings. Age of the population, conditioning regimens and GvHD prophylaxis are summarized in the table. The rates of Grade 2-4 aGvHD (OR 1.7 ; 95% CI 1.43-2.02 p<0.001,I²: %24 ), Grade 3-4 aGvHD (OR 1.87 ; 95% CI 1.45-2.42 p<0.001, I²: %0) and cGvHD (OR 2.35 ; 95% CI 2.01-2.74 p<0.001, I²: %73.5) were significantly lower in patients who underwent Allo-HSCT with BM. Conclusions The current systematic review and meta-analysis demonstrated that SAA patients who underwent AHSCT with BM had better outcomes in regards to aGvHD as well as reduced incidence of chronic GVHD. Further larger randomized studies are needed to better delineate the role of PBSC in SAA. Figure 1View largeDownload PPTFigure 1View largeDownload PPT Close modal

Objective: Studies comparing the efficacy and safety of prophylactic regimens for central nervous system (CNS) involvement in acute lymphoblastic leukemia (ALL) are scarce in adults. This multicenter retrospective study aimed to compare the efficacy of prophylactic regimens with and without CNS irradiation on the development of CNS relapse during follow-up. Materials and Methods: This was a multicenter comparative cohort study. A total of 203 patients were included from four tertiary care centers in Turkey. Patients were divided into two groups according to whether they received CNS irradiation or not. The groups were analyzed retrospectively regarding patient and disease characteristics, with the main focus being CNS relapse. Results: While 105 patients received chemotherapy-based prophylaxis, 98 patients received additional CNS irradiation. These groups were statistically comparable in terms of demographic characteristics and risk factors for CNS involvement. In the irradiation group, patients were younger and had more stem cell transplants. In a median of 23.8 (11.1-62.4) months, there was no difference between the two groups regarding CNS relapse-free survival (log-rank p=0.787). Conclusion: Craniospinal irradiation may not be indispensable for every adult patient with ALL, similarly to pediatric patients. It is crucial to avoid the long-term toxicities of radiation, especially in patients with long life expectancy. Craniospinal irradiation may be reserved for therapeutic use in cases of CNS relapse and prophylaxis for some high-risk patients.

Background/aim: The disease caused by SARS-CoV-2 was named as COVID-19. There is as yet insufficient information about the effects of HSCT on the clinical course of COVID-19. In the present study, we aimed to investigate the clinical course of COVID-19 in patients who had undergone HSCT. Materials and methods: We analyzed baseline characteristics, clinical course and findings of COVID-19, hospitalization and death rates, overall survival, and case fatality rates of HSCT recipients diagnosed with COVID-19 retrospectively. Results: 57.6% of the patients underwent AHSCT, and 42.4% underwent allo-HSCT. 60.6%, 27.3%, and 12.1% of the patients had mild, moderate, and severe COVID-19 or critical illness, respectively. Overall, 45.5% were hospitalized, 12.1% required intensive care, and 9.1% necessitated invasive mechanical ventilation. The total CFR was 9.1% in HSCT recipients, 22.2% in patients with active hematologic malignancy, and 4.2% in patients without active hematologic malignancy. Conclusion: It can be concluded that mortality of HSCT recipients is lower in patients whose primary disease is in remission compared to ones that are not in remission. Further studies with larger group patients are needed in order to delineate the effects of COVID-19 on HSCT patients.

OBJECTIVE:Aplastic anemia (AA) is a life-threatening disorder and may be associated with significant morbidity and mortality Currently, the first treatment option is allogeneic hematopoietic stem cell transplant (allo-HSCT) for patients younger than 40 years. Bone marrow is recommended as the stem cell source due to less graft versus host disease (GVHD) risk and better outcomes than peripheral blood (PB)-derived stem cell. The aim of this study is to share the data of AA patients who have underwent PB-derived allo-HSCT in our bone marrow transplantation center.METHODS:Twenty-seven patients who underwent PB-derived allo-HSCT from human leukocyte antigen matched sibling donors were analyzed retrospectively.RESULTS:The median follow-up time was 95.2 months (range, 4.8-235 months). The 10-year survival was 89 %. The median neutrophil and platelet engraftment time was 11 days (range, 9-16 days) and 13 days (range, 11-29 days), respectively. Primary platelet engraftment failure was observed in 1 patient (3.7 %). Acute and chronic GVHD observed in 2 (7.4 %) and 3 (11.1 %) patients, respectively. Neutropenic fever was observed in 13 (44.8 %) of patients until the engraftment after allo-HSCT. One patient died due to CMV infections, two died due to septic shock secondary to fungal infection.CONCLUSION:Although there is no prospective data directly comparing BM with PB as stem cell source in AA, observational studies indicates better OS with BM. PB can be used in certain situations such as higher risk for graft failure and donor preference. This study demonstrated that PB-derived stem cell seems to be a reasonable alternative to BM.

respectively, p < 0.001), and CMV disease in initially-viremic patients (2.1%, 33.0%, and 0%, respectively, p < 0.001). Conclusion: We can conclude that Haploidentical HSCT is associated with promising outcomes in terms of successful engraftment and reduced complications. Engraftment success has been noticed in the majority of patients with severe and very severe AA, while TRM and GvHD rates were acceptable. NMA conditioning was better in terms of lower CMV viremia and acute GVHD but not in terms of RRT, mortality and engraftment. The addition of PTCy regimens have showed lower GvHD and lower CMV incidence at a price of non-significant increase in the incidence of mortality per year. NMA vs. RIC and PTCy vs others may be used depending on both patient’s and donor’s profiles besides each institution’s setup and resources Recommendation: Still we are in need of more studies to weigh the risk and benefits of Haplo SCT in AA.

INTRODUCTION:Acute lymphoblastic leukemia (ALL) is a malign disease with poor prognosis in adults. After remission is achieved by induction therapy, administration of allogeneic hematopoietic stem-cell transplantation (AHSCT) is one of the standard treatment in adult ALL patients. Pediatric-inspired chemotherapy has been demonstrated to improve outcomes of adult ALL. The aim of this study was to compare the Berlin-Frankfurt-Münster-95 chemotherapy (BFM-95) regimen and AHSCT results in ALL patients with first complete remission. PATIENTS AND METHODS:Forty-seven patients who received the BFM-95 regimen and 83 patients who underwent AHSCT were compared. Primary endpoints were comparison of overall survival (OS) and disease-free survival (DFS) between groups. RESULTS:There was no significant difference between the groups in terms of age, gender, or performance status. In BFM-95 and AHSCT, relapsed disease occurred in 11 (23.4%) and 24 (28.9%), respectively; the respective values for treatment-related mortality were 6 (12.7%) and 10 (12%) (P = .32 and .91). Five-year DFS was 38% with BFM-95 and 57% with AHSCT (P = .014). There was no 5-year OS difference in both groups (64% vs 60%, P = .13). While leukocyte count < 30 × 109/L at the time of diagnosis (hazard ratio, 2.7; P = .021) and prophylaxis of central nervous system (hazard ratio, 2; P = .036) were prognostic for OS, the only factor that had a prognostic effect on DFS was AHSCT (hazard ratio, 1.6; P = .041). CONCLUSION:AHSCT currently offers no special OS advantage but increases DFS compared to the BFM-95 regimen. AHSCT may be considered at first complete remission in patients at low risk of transplant-related mortality.

Background/aim Graft-versus-host disease (GVHD) is a crucial complication leading to significant morbidity and mortality allogeneic hematopoietic stem cell transplantation which occurs in approximately half of the transplant recipients. Suppression of tumorigenicity 2 (ST2) and regenerating islet-derived 3-alpha(Reg3a) might be important biomarkers to predict acute GVHD. Materials and methods In the present study, blood samples were collected from 17 patients with acute GVHD and 12 control patients after allogeneic stem cell transplantation. ST2 and Reg3a were measured in plasma samples compared in patients with acute GVHD and the controls. Results Median age of the study population was 42 years (range 19–49). When compared to controls, the mean ST2 levels was significant higher in acute GVHD (9794 ng/dL vs. 2646 ng/dL, P = 0.008). Mean Reg3a level did not show significant difference between control and acute GVHD group (8848 ng/dL vs. 5632 ng/dL, respectively, P = 0.190). Conclusion The ST2 level might be used as a significant biomarker for predicting acute GVHD.

BACKGROUND:Autologous stem cell transplantation (ASCT) is one of the standard treatments of choice for eligible multiple myeloma (MM) patients. Herein, we aimed to analyze MM patients at our center and compare the clinical outcomes of single and double ASCT patients.MATERIALS AND METHODS:Patients who were diagnosed as having MM and had undergone single or double ASCT in our clinic between the years 2003 and 2020 were retrospectively examined.RESULTS:In this study, the median time of second ASCT is approximately 3.6 years from the first ASCT. Overall survival (OS) duration of the single and double transplanted groups was 4,011 ± 266 vs 3,526 ± 326 days, respectively (p: 0.33). Progression-free survival (PFS) duration of the single and double transplanted groups was 2,344 ± 228 vs 685 ± 120 days, respectively (p: 0.22). Disease assessment after ASCT stable or progressive disease, partial remission, and very good partial or complete remission (CR) in single and double ASCT groups was 62/44/105 and 8/4/5, respectively (p: 0.22).CONCLUSION:The present study points out that the second ASCT treatment option for MM patients may not be effective as suggested, especially in the era of novel MM drugs, since our results come from the past data that novel drugs were not exist. In conclusion, we found no benefit with second ASCT in MM patients in terms of PFS and OS or CR rates, and the novel anti-myeloma drugs might decrease the need for a second transplant.

Objective: Allogeneic hematopoietic stem cell transplantation (AHSCT) is a potentially curative treatment of choice for many hematological diseases. However, there are some transplantation-related risks. Predicting the risk–benefit ratio prior to AHSCT facilitates the choice of conditioning regimens and post-transplant follow-up. Hence, many risk models have been developed. The aim of the present study was to compare six different risk models clinically used. Material and Methods: Hematological malignancies were enrolled in this study. The European Group for Blood and Marrow Transplantation (EBMT), Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI), Age-Adjusted Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI-Age) , revised Pretransplant Assessment of Mortality Score (rPAM), acute leukemia-EBMT score (AL-EBMT) and Disease risk index (DRI) risk models were applied retrospectively. Results: AL-EBMT, HCT-CI, HCT-CI-Age, risk scoring systems were found to be predictive for 2-year OS and 2-year NRM (2-year OS; (AL-EBMT: reference vs score 8.5-10 HR:1.3 p:0.035 reference vs score >10 HR: 3.8 p:0.001, HCT-CI: reference vs score 12 HR:1.4 p:0.018 reference vs score ≥3 HR:2.5 p<0.001, HCT-CI-Age reference vs scoe 12 HR: 1.3 p:<0.001 reference vs score ≥3 HR:3,2 p<0.001 2-year NRM: AL-EBMT: reference vs score 8.5-10 HR:1.61 p<0.001 reference vs score >10 HR: 3.3 p: <0.001 HCTCI: reference vs 1-2 HR:1.3 p:0.028 reference vs score ≥3 HR:2.3 p:0.011 HCT-CI-Age reference vs score 1-2 HR: 1.3 p:0.01 reference vs score ≥3 HR: 2.4 p: 0.003). In terms of Kaplan Meier estimate of 2-year OS and 2-year NRM, the risk scoring systems having the highest predictive power was found to be AL-EBMT (2-year AUC; 0.59-0.60, respectively). The other scores were not found to be predictive for 2-year OS and NRM. Conclusion: In the present study at our bone marrow and stem cell transplant center, it has been demonstrated that the HCT-CI, HCT-CI-Age, and AL-EBMT were good predictors of 2year NRM and OS.