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The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation
The aim of this study was to develop a predictive score for moderate-severe chronic graft-versus-host disease (cGVHD) on day +100 after allogeneic stem cell transplantation (HSCT). We studied 1292 patients allografted between 1990 and 2016, alive on day +100 after transplant, without cGVHD, and with...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
American Society of Hematology
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006267/ https://www.ncbi.nlm.nih.gov/pubmed/34920451 http://dx.doi.org/10.1182/bloodadvances.2021005675 |
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author | Metafuni, Elisabetta Cavattoni, Irene Maria Lamparelli, Teresa Raiola, Anna Maria Ghiso, Anna Galaverna, Federica Gualandi, Francesca Di Grazia, Carmen Dominietto, Alida Varaldo, Riccardo Signori, Alessio Chiusolo, Patrizia Sora’, Federica Giammarco, Sabrina Laurenti, Luca Sica, Simona Angelucci, Emanuele Bacigalupo, Andrea |
author_facet | Metafuni, Elisabetta Cavattoni, Irene Maria Lamparelli, Teresa Raiola, Anna Maria Ghiso, Anna Galaverna, Federica Gualandi, Francesca Di Grazia, Carmen Dominietto, Alida Varaldo, Riccardo Signori, Alessio Chiusolo, Patrizia Sora’, Federica Giammarco, Sabrina Laurenti, Luca Sica, Simona Angelucci, Emanuele Bacigalupo, Andrea |
author_sort | Metafuni, Elisabetta |
collection | PubMed |
description | The aim of this study was to develop a predictive score for moderate-severe chronic graft-versus-host disease (cGVHD) on day +100 after allogeneic stem cell transplantation (HSCT). We studied 1292 patients allografted between 1990 and 2016, alive on day +100 after transplant, without cGVHD, and with full biochemistry laboratory values available. Patients were randomly assigned to a training and a validation cohort (ratio 1:1). In the training cohort, a multivariate analysis identified 4 independent predictors of moderate-severe cGVHD: gamma-glutamyl transferase ≥75 UI/l, creatinine ≥1 mg/dl, cholinesterase ≤4576 UI/l, and albumin ≤4 g/dl. A score of 1 was assigned to each variable, producing a low (0 to 1), intermediate (2 to 3), and high (4) score. The cumulative incidence of moderate-severe cGVHD was 12%, 20%, and 52% (P < .0001) in the training cohort, and 13%, 24%, and 33% (P = .002) in the validation cohort, respectively. The 5-year cumulative incidence of transplant-related mortality (TRM) was 5%, 14%, 27% (P < .0001) and 5%, 16%, 31% (P < .0001), respectively. The 5-year survival was 64%, 57%, 54% (P = .009) and 70%, 59%, 42% (P = .0008) in the 2 cohorts, respectively. In conclusion, Day100 score predicts cGVHD, TRM, and survival and, if validated in a separate group of patients, could be considered for trials of preemptive therapy. |
format | Online Article Text |
id | pubmed-9006267 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | American Society of Hematology |
record_format | MEDLINE/PubMed |
spelling | pubmed-90062672022-04-13 The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation Metafuni, Elisabetta Cavattoni, Irene Maria Lamparelli, Teresa Raiola, Anna Maria Ghiso, Anna Galaverna, Federica Gualandi, Francesca Di Grazia, Carmen Dominietto, Alida Varaldo, Riccardo Signori, Alessio Chiusolo, Patrizia Sora’, Federica Giammarco, Sabrina Laurenti, Luca Sica, Simona Angelucci, Emanuele Bacigalupo, Andrea Blood Adv Transplantation The aim of this study was to develop a predictive score for moderate-severe chronic graft-versus-host disease (cGVHD) on day +100 after allogeneic stem cell transplantation (HSCT). We studied 1292 patients allografted between 1990 and 2016, alive on day +100 after transplant, without cGVHD, and with full biochemistry laboratory values available. Patients were randomly assigned to a training and a validation cohort (ratio 1:1). In the training cohort, a multivariate analysis identified 4 independent predictors of moderate-severe cGVHD: gamma-glutamyl transferase ≥75 UI/l, creatinine ≥1 mg/dl, cholinesterase ≤4576 UI/l, and albumin ≤4 g/dl. A score of 1 was assigned to each variable, producing a low (0 to 1), intermediate (2 to 3), and high (4) score. The cumulative incidence of moderate-severe cGVHD was 12%, 20%, and 52% (P < .0001) in the training cohort, and 13%, 24%, and 33% (P = .002) in the validation cohort, respectively. The 5-year cumulative incidence of transplant-related mortality (TRM) was 5%, 14%, 27% (P < .0001) and 5%, 16%, 31% (P < .0001), respectively. The 5-year survival was 64%, 57%, 54% (P = .009) and 70%, 59%, 42% (P = .0008) in the 2 cohorts, respectively. In conclusion, Day100 score predicts cGVHD, TRM, and survival and, if validated in a separate group of patients, could be considered for trials of preemptive therapy. American Society of Hematology 2022-04-05 /pmc/articles/PMC9006267/ /pubmed/34920451 http://dx.doi.org/10.1182/bloodadvances.2021005675 Text en © 2022 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved. |
spellingShingle | Transplantation Metafuni, Elisabetta Cavattoni, Irene Maria Lamparelli, Teresa Raiola, Anna Maria Ghiso, Anna Galaverna, Federica Gualandi, Francesca Di Grazia, Carmen Dominietto, Alida Varaldo, Riccardo Signori, Alessio Chiusolo, Patrizia Sora’, Federica Giammarco, Sabrina Laurenti, Luca Sica, Simona Angelucci, Emanuele Bacigalupo, Andrea The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation |
title | The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation |
title_full | The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation |
title_fullStr | The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation |
title_full_unstemmed | The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation |
title_short | The day 100 score predicts moderate to severe cGVHD, transplant mortality, and survival after hematopoietic cell transplantation |
title_sort | day 100 score predicts moderate to severe cgvhd, transplant mortality, and survival after hematopoietic cell transplantation |
topic | Transplantation |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9006267/ https://www.ncbi.nlm.nih.gov/pubmed/34920451 http://dx.doi.org/10.1182/bloodadvances.2021005675 |
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