Optimized EBMT transplant-specific risk ...
Type de document :
Article dans une revue scientifique: Article original
PMID :
URL permanente :
Titre :
Optimized EBMT transplant-specific risk score in myelodysplastic syndromes after allogeneic stem-cell transplantation.
Auteur(s) :
Gagelmann, Nico [Auteur]
Eikema, Diderik-Jan [Auteur]
Stelljes, Matthias [Auteur]
Beelen, Dietrich [Auteur]
De Wreede, Liesbeth C. [Auteur]
Mufti, Ghulam [Auteur]
Knelange, Nina Simone [Auteur]
Niederwieser, Dietger [Auteur]
Friis, Lone S [Auteur]
Ehnninger, Gerhard [Auteur]
Nagler, Arnon [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Meijer, Ellen [Auteur]
Ljungman, Per [Auteur]
Maertens, Johan [Auteur]
Kanz, Lothar [Auteur]
Lopez-Corral, Lucia [Auteur]
Brecht, Arne [Auteur]
Craddock, Charles [Auteur]
Finke, Jurgen [Auteur]
Cornelissen, Jan J [Auteur]
Bernasconi, Paolo [Auteur]
Chevallier, Patrice [Auteur]
Sierra, Jorge [Auteur]
Robin, Marie [Auteur]
Kroger, Nicolaus [Auteur]
Eikema, Diderik-Jan [Auteur]
Stelljes, Matthias [Auteur]
Beelen, Dietrich [Auteur]
De Wreede, Liesbeth C. [Auteur]
Mufti, Ghulam [Auteur]
Knelange, Nina Simone [Auteur]
Niederwieser, Dietger [Auteur]
Friis, Lone S [Auteur]
Ehnninger, Gerhard [Auteur]
Nagler, Arnon [Auteur]
Yakoub-Agha, Ibrahim [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Meijer, Ellen [Auteur]
Ljungman, Per [Auteur]
Maertens, Johan [Auteur]
Kanz, Lothar [Auteur]
Lopez-Corral, Lucia [Auteur]
Brecht, Arne [Auteur]
Craddock, Charles [Auteur]
Finke, Jurgen [Auteur]
Cornelissen, Jan J [Auteur]
Bernasconi, Paolo [Auteur]
Chevallier, Patrice [Auteur]
Sierra, Jorge [Auteur]
Robin, Marie [Auteur]
Kroger, Nicolaus [Auteur]
Titre de la revue :
Haematologica
Nom court de la revue :
Haematologica
Numéro :
104
Pagination :
929-936
Date de publication :
2019-05
ISSN :
1592-8721
Discipline(s) HAL :
Sciences du Vivant [q-bio]
Résumé en anglais : [en]
The aim of this study was to develop and validate a clinical and transplant-specific prognostic score using data from a large cohort of patients with myelodysplastic syndromes reported to the European Society for Blood and ...
Lire la suite >The aim of this study was to develop and validate a clinical and transplant-specific prognostic score using data from a large cohort of patients with myelodysplastic syndromes reported to the European Society for Blood and Marrow Transplantation registry. A Cox model was fitted to detect clinical and transplant-related variables prognostic of outcome. Then, cross-validation was performed to evaluate the validity and consistency of the model. Seven independent risk factors for survival were identified: age ≥50 years, matched unrelated donor, Karnofsky Performance Status <90%, very poor cytogenetics or monosomal karyotype, positive cytomegalovirus status of the recipient, blood blasts >1%, and platelet count ≤50 × 10 /L prior to transplantation. Incorporating these factors into a four-level risk score yielded hazard ratios for death, with low-risk (score of 0-1) as reference, of 2.02 (95% CI: 1.41-2.90) for the intermediate-risk group (score of 2-3), 3.49 (95% CI: 2.45-4.97) for the high-risk group (score of 4-5), and 5.90 (95% CI: 4.01-8.67) for the very high-risk group (score of >5). The score was predictive of survival, relapse-free survival, relapse, and non-relapse mortality ( <0.001, respectively). Cross-validation yielded significant and reproducible improvement in prognostic ability with C-statistics being 0.609 (95% CI: 0.588-0.629) 0.555 for the registry and 0.579 for the Center for Blood and Marrow Transplant Research registry. Prediction was even further augmented after applying a nomogram using age and platelets as continuous variables showing C-statistics of 0.628 (95% CI: 0.616-0.637). In conclusion, compared to existing prognostic systems, this proposed transplant-specific risk score offers improved performance with respect to post-transplant risk stratification in myelodysplastic syndromes.Lire moins >
Lire la suite >The aim of this study was to develop and validate a clinical and transplant-specific prognostic score using data from a large cohort of patients with myelodysplastic syndromes reported to the European Society for Blood and Marrow Transplantation registry. A Cox model was fitted to detect clinical and transplant-related variables prognostic of outcome. Then, cross-validation was performed to evaluate the validity and consistency of the model. Seven independent risk factors for survival were identified: age ≥50 years, matched unrelated donor, Karnofsky Performance Status <90%, very poor cytogenetics or monosomal karyotype, positive cytomegalovirus status of the recipient, blood blasts >1%, and platelet count ≤50 × 10 /L prior to transplantation. Incorporating these factors into a four-level risk score yielded hazard ratios for death, with low-risk (score of 0-1) as reference, of 2.02 (95% CI: 1.41-2.90) for the intermediate-risk group (score of 2-3), 3.49 (95% CI: 2.45-4.97) for the high-risk group (score of 4-5), and 5.90 (95% CI: 4.01-8.67) for the very high-risk group (score of >5). The score was predictive of survival, relapse-free survival, relapse, and non-relapse mortality ( <0.001, respectively). Cross-validation yielded significant and reproducible improvement in prognostic ability with C-statistics being 0.609 (95% CI: 0.588-0.629) 0.555 for the registry and 0.579 for the Center for Blood and Marrow Transplant Research registry. Prediction was even further augmented after applying a nomogram using age and platelets as continuous variables showing C-statistics of 0.628 (95% CI: 0.616-0.637). In conclusion, compared to existing prognostic systems, this proposed transplant-specific risk score offers improved performance with respect to post-transplant risk stratification in myelodysplastic syndromes.Lire moins >
Langue :
Anglais
Audience :
Internationale
Vulgarisation :
Non
Établissement(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Date de dépôt :
2019-10-22T07:44:38Z
2023-12-01T16:20:45Z
2023-12-01T16:20:45Z
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