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Prediction of Nonrelapse Mortality in Patients With Acute Myeloid Leukemia and Acute Lymphoblastic Leukemia Receiving Allogeneic Stem Cell Transplantation With Posttransplantation Cyclophosphamide-based Graft Versus Host Disease Prophylaxis
SJF. Hermans, J. Versluis, M. Labopin, S. Giebel, Y. van Norden, I. Moiseev, D. Blaise, JL. Díez Martín, E. Meijer, M. Rovira, G. Choi, AM. Raiola, Y. Koc, P. Reményi, J. Vydra, N. Kröger, S. Sica, M. Martino, G. van Gorkom, P. Chevallier, A....
Status neindexováno Jazyk angličtina Země Spojené státy americké
Typ dokumentu časopisecké články
NLK
Directory of Open Access Journals
od 2017
PubMed Central
od 2017
Europe PubMed Central
od 2017
Wiley-Blackwell Open Access Titles
od 1997
- Publikační typ
- časopisecké články MeSH
Graft versus host disease (GVHD) prophylaxis with posttransplantation cyclophosphamide (PTCY) has been established to reduce severe GVHD, and thereby potentially reducing nonrelapse mortality (NRM) after allogeneic stem cell transplantation (alloSCT). We evaluated the predictive capacity of established NRM-risk scores in patients receiving PTCY-based GVHD prophylaxis, and subsequently developed and validated a novel PTCY-specific NRM-risk model. Adult patients (n = 1861) with AML or ALL in first complete remission who received alloSCT with PTCY-based GVHD prophylaxis were included. The PTCY-risk score was developed using multivariable Fine and Gray regression, selecting parameters from the hematopoietic cell transplantation-comorbidity index (HCT-CI) and European Group for Blood and Marrow Transplantation (EBMT) score with a subdistribution hazard ratio (SHR) of ≥1.2 for 2-year NRM in the training set (70% split), which was validated in the test set (30%). The performance of the EBMT score, HCT-CI, and integrated EBMT score was relatively poor for discriminating 2-year NRM (c-statistic 51.7%, 56.6%, and 59.2%, respectively). The PTCY-risk score included 10 variables which were collapsed in 3 risk groups estimating 2-year NRM of 11% ± 2%, 19% ± 2%, and 36% ± 3% (training set, c-statistic 64%), and 11% ± 2%, 18% ± 3%, and 31% ± 5% (test set, c-statistic 63%), which also translated into different overall survival. Collectively, we developed an NRM-risk score for acute leukemia patients receiving PTCY that better predicted 2-year NRM compared with existing models, which might be applicable to the specific toxicities of high-dose cyclophosphamide.
CHU Nantes Department of D'Hematologie Nantes France
Department of Hematology Hôpital Saint Antoine Paris France
Department of Hematology Hospital Clinic Institute of Hematology and Oncology Barcelona Spain
Department of Hematology Reina Sofía University Hospital IMIBIC University of Cordoba Spain
Department of Hematology VU University Medical Center Amsterdam The Netherlands
Erasmus MC Cancer Institute University Medical Center Rotterdam The Netherlands
Hematology and Bone Marrow Transplant Department Chaim Sheba Medical Center Tel Hashomer Israel
Institute of Hematology and Blood Transfusion Prague Czech Republic
IRCCS Policlinico San Martino Hospital Genova Italy
Medicana International Bone Marrow Transplant Unit Istanbul Turkey
RM Gorbacheva Research Institute Pavlov University St Petersburg Russia
S S C 5 D Trapianto di Cellule Staminali A O U Citta della Salute e della Scienza di Torino Italy
University Hospital Center Zagreb School of Medicine University of Zagreb Croatia
University Hospital Eppendorf Bone Marrow Transplantation Centre Hamburg Germany
University Medical Center Groningen University of Groningen The Netherlands
Citace poskytuje Crossref.org
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