A disease risk index for patients undergoing allogeneic stem cell transplantation
A disease risk index for patients undergoing allogeneic stem cell transplantation
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DOI：
10.1182/blood-2012-03-418202
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发表时间：
2012-07-26
期刊：
影响因子：
20.3
通讯作者：
Kim, Haesook T.
中科院分区：
文献类型：
--
作者：
Armand, Philippe;Gibson, Christopher J.;Kim, Haesook T.
同种异体造血干细胞移植的结果因疾病和移植时的缓解状态而有很大差异。任何纳入不同疾病类型患者的回顾性或前瞻性HSCT研究都必须考虑到这种异质性；然而，目前的方法既没有标准化，也没有经过验证。我们对2000年至2009年在丹娜-法伯癌症研究所/布里格姆妇女医院接受移植的1539例患者进行了回顾性研究。使用多变量总体生存模型，我们创建了一个疾病风险指数。该工具使用现成的疾病和疾病状态信息，以复发风险的主要差异为基础，将患者分为4个总生存期和无进展生存期显著不同的风险组。该方案适用于任何条件强度，独立于合并症指数，并在Fred Hutchinson癌症研究中心的672例患者的独立队列中得到验证。这个简单且经过验证的方案可用于回顾性和前瞻性HSCT研究中的患者风险分层，校准不同研究和中心的HSCT结果，促进设计不同疾病和疾病状态的HSCT临床试验，提高我们研究HSCT非疾病特异性结果的能力。(血。2012;120 (4):905 - 913)
The outcome of allogeneic HSCT varies considerably by the disease and remission status at the time of transplantation. Any retrospective or prospective HSCT study that enrolls patients across disease types must account for this heterogeneity; yet, current methods are neither standardized nor validated. We conducted a retrospective study of 1539 patients who underwent transplantation at Dana-Farber Cancer Institute/Brigham and Women's Hospital from 2000 to 2009. Using multivariable models for overall survival, we created a disease risk index. This tool uses readily available information about disease and disease status to categorize patients into 4 risk groups with significantly different overall survival and progression-free survival on the basis of primarily differences in the relapse risk. This scheme applies regardless of conditioning intensity, is independent of comorbidity index, and was validated in an independent cohort of 672 patients from the Fred Hutchinson Cancer Research Center. This simple and validated scheme could be used to risk-stratify patients in both retrospective and prospective HSCT studies, to calibrate HSCT outcomes across studies and centers, and to promote the design of HSCT clinical trials that enroll patients across diseases and disease states, increasing our ability to study nondisease-specific outcomes in HSCT. (Blood. 2012;120(4):905-913)