Personalized prediction of overall survival in patients with AML in non-complete remission undergoing allo-HCT

© 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd..

Allogenic hematopoietic stem cell transplantation (allo-HCT) is the standard treatment for acute myeloid leukemia (AML) in non-complete remission (non-CR); however, the prognosis is inconsistent. This study aimed to develop and validate nomograms and a web application to predict the overall survival (OS) of patients with non-CR AML undergoing allo-HCT (cord blood transplantation [CBT], bone marrow transplantation [BMT], and peripheral blood stem cell transplantation [PBSCT]). Data from 3052 patients were analyzed to construct and validate the prognostic models. The common significant prognostic factors among patients undergoing allo-HCT were age, performance status, percentage of peripheral blasts, cytogenetic risk, chemotherapy response, and number of transplantations. The conditioning regimen was a significant prognostic factor only in patients undergoing CBT. Compared with cyclophosphamide/total body irradiation, a conditioning regimen of ≥3 drugs, including fludarabine, with CBT exhibited the lowest hazard ratio for mortality (0.384; 95% CI, 0.266-0.554; p < 0.0001). A conditioning regimen of ≥3 drugs with CBT also showed the best leukemia-free survival among all conditioning regimens. Based on the results of the multivariable analysis, we developed prognostic models showing adequate calibration and discrimination (the c-indices for CBT, BMT, and PBSCT were 0.648, 0.600, and 0.658, respectively). Our prognostic models can help in assessing individual risks and designing future clinical studies. Furthermore, our study indicates the effectiveness of multi-drug conditioning regimens in patients undergoing CBT.

Medienart:

E-Artikel

Erscheinungsjahr:

2021

Erschienen:

2021

Enthalten in:

Zur Gesamtaufnahme - volume:10

Enthalten in:

Cancer medicine - 10(2021), 13 vom: 02. Juli, Seite 4250-4268

Sprache:

Englisch

Beteiligte Personen:

Hirabayashi, Shigeki [VerfasserIn]
Uozumi, Ryuji [VerfasserIn]
Kondo, Tadakazu [VerfasserIn]
Arai, Yasuyuki [VerfasserIn]
Kawata, Takahito [VerfasserIn]
Uchida, Naoyuki [VerfasserIn]
Marumo, Atsushi [VerfasserIn]
Ikegame, Kazuhiro [VerfasserIn]
Fukuda, Takahiro [VerfasserIn]
Eto, Tetsuya [VerfasserIn]
Tanaka, Masatsugu [VerfasserIn]
Wake, Atsushi [VerfasserIn]
Kanda, Junya [VerfasserIn]
Kimura, Takafumi [VerfasserIn]
Tabuchi, Ken [VerfasserIn]
Ichinohe, Tatsuo [VerfasserIn]
Atsuta, Yoshiko [VerfasserIn]
Yanada, Masamitsu [VerfasserIn]
Yano, Shingo [VerfasserIn]

Links:

Volltext

Themen:

04079A1RDZ
8N3DW7272P
Acute myeloid leukemia
Busulfan
Cyclophosphamide
Cytarabine
FA2DM6879K
Fludarabine
G1LN9045DK
Hematopoietic stem cell transplantation
Immunosuppressive Agents
Journal Article
Melphalan
Multicenter Study
Nomogram
Non-complete remission
P2K93U8740
Q41OR9510P
Research Support, Non-U.S. Gov't
Validation Study
Vidarabine
Web application

Anmerkungen:

Date Completed 31.12.2021

Date Revised 31.12.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1002/cam4.3920

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM326801316