A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation
Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license..
BACKGROUND: For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT.
METHODS: A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables.
RESULTS: All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P < 0.001, P = 0.004, and P < 0.001, respectively) and worse LFS (P < 0.001, P = 0.017, and P < 0.001, respectively), and OS (P < 0.001, P = 0.009, and P < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score.
CONCLUSION: This new risk score system might stratify patients with different risks of relapse, which could guide treatment.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:134 |
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| Enthalten in: |
Chinese medical journal - 134(2021), 10 vom: 12. März, Seite 1199-1208 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cao, Le-Qing [VerfasserIn] |
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| Anmerkungen: |
Date Completed 25.05.2021 Date Revised 19.01.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1097/CM9.0000000000001402 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM322907101 |
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| 100 | 1 | |a Cao, Le-Qing |e verfasserin |4 aut | |
| 245 | 1 | 2 | |a A risk score system for stratifying the risk of relapse in B cell acute lymphocytic leukemia patients after allogenic stem cell transplantation |
| 264 | 1 | |c 2021 | |
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| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
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| 500 | |a Date Completed 25.05.2021 | ||
| 500 | |a Date Revised 19.01.2024 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. | ||
| 520 | |a BACKGROUND: For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT | ||
| 520 | |a METHODS: A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables | ||
| 520 | |a RESULTS: All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P < 0.001, P = 0.004, and P < 0.001, respectively) and worse LFS (P < 0.001, P = 0.017, and P < 0.001, respectively), and OS (P < 0.001, P = 0.009, and P < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score | ||
| 520 | |a CONCLUSION: This new risk score system might stratify patients with different risks of relapse, which could guide treatment | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Zhou, Yang |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Yan-Rong |e verfasserin |4 aut | |
| 700 | 1 | |a Xu, Lan-Ping |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Xiao-Hui |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Huan |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Yu-Hong |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Feng-Rong |e verfasserin |4 aut | |
| 700 | 1 | |a Han, Wei |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Yu-Qian |e verfasserin |4 aut | |
| 700 | 1 | |a Yan, Chen-Hua |e verfasserin |4 aut | |
| 700 | 1 | |a Tang, Fei-Fei |e verfasserin |4 aut | |
| 700 | 1 | |a Mo, Xiao-Dong |e verfasserin |4 aut | |
| 700 | 1 | |a Liu, Kai-Yan |e verfasserin |4 aut | |
| 700 | 1 | |a Fan, Qiao-Zhen |e verfasserin |4 aut | |
| 700 | 1 | |a Chang, Ying-Jun |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Xiao-Jun |e verfasserin |4 aut | |
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