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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
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 establis...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946411/ https://www.ncbi.nlm.nih.gov/pubmed/36844179 http://dx.doi.org/10.1097/HS9.0000000000000846 |
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author | Hermans, Sjoerd J. F. Versluis, Jurjen Labopin, Myriam Giebel, Sebastian van Norden, Yvette Moiseev, Ivan Blaise, Didier Díez Martín, Jose L. Meijer, Ellen Rovira, Montserrat Choi, Goda Raiola, Anna Maria Koc, Yener Reményi, Péter Vydra, Jan Kröger, Nicolaus Sica, Simona Martino, Massimo van Gorkom, Gwendolyn Chevallier, Patrice Busca, Alessandro Herrera Arroyo, Concepcion Brissot, Eolia Peric, Zinaida Nagler, Arnon Shouval, Roni Ciceri, Fabio Cornelissen, Jan J. Mohty, Mohamad |
author_facet | Hermans, Sjoerd J. F. Versluis, Jurjen Labopin, Myriam Giebel, Sebastian van Norden, Yvette Moiseev, Ivan Blaise, Didier Díez Martín, Jose L. Meijer, Ellen Rovira, Montserrat Choi, Goda Raiola, Anna Maria Koc, Yener Reményi, Péter Vydra, Jan Kröger, Nicolaus Sica, Simona Martino, Massimo van Gorkom, Gwendolyn Chevallier, Patrice Busca, Alessandro Herrera Arroyo, Concepcion Brissot, Eolia Peric, Zinaida Nagler, Arnon Shouval, Roni Ciceri, Fabio Cornelissen, Jan J. Mohty, Mohamad |
author_sort | Hermans, Sjoerd J. F. |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-9946411 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-99464112023-02-23 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 Hermans, Sjoerd J. F. Versluis, Jurjen Labopin, Myriam Giebel, Sebastian van Norden, Yvette Moiseev, Ivan Blaise, Didier Díez Martín, Jose L. Meijer, Ellen Rovira, Montserrat Choi, Goda Raiola, Anna Maria Koc, Yener Reményi, Péter Vydra, Jan Kröger, Nicolaus Sica, Simona Martino, Massimo van Gorkom, Gwendolyn Chevallier, Patrice Busca, Alessandro Herrera Arroyo, Concepcion Brissot, Eolia Peric, Zinaida Nagler, Arnon Shouval, Roni Ciceri, Fabio Cornelissen, Jan J. Mohty, Mohamad Hemasphere Article 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. Lippincott Williams & Wilkins 2023-02-21 /pmc/articles/PMC9946411/ /pubmed/36844179 http://dx.doi.org/10.1097/HS9.0000000000000846 Text en Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the European Hematology Association. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Article Hermans, Sjoerd J. F. Versluis, Jurjen Labopin, Myriam Giebel, Sebastian van Norden, Yvette Moiseev, Ivan Blaise, Didier Díez Martín, Jose L. Meijer, Ellen Rovira, Montserrat Choi, Goda Raiola, Anna Maria Koc, Yener Reményi, Péter Vydra, Jan Kröger, Nicolaus Sica, Simona Martino, Massimo van Gorkom, Gwendolyn Chevallier, Patrice Busca, Alessandro Herrera Arroyo, Concepcion Brissot, Eolia Peric, Zinaida Nagler, Arnon Shouval, Roni Ciceri, Fabio Cornelissen, Jan J. Mohty, Mohamad 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 |
title | 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 |
title_full | 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 |
title_fullStr | 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 |
title_full_unstemmed | 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 |
title_short | 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 |
title_sort | 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 |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9946411/ https://www.ncbi.nlm.nih.gov/pubmed/36844179 http://dx.doi.org/10.1097/HS9.0000000000000846 |
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