Development of a Nomogram for Predicting the Cumulative Incidence of Disease Recurrence of AML After Allo-HSCT.
Development of a Nomogram for Predicting the Cumulative Incidence of Disease Recurrence of AML After Allo-HSCT.
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开发列线图来预测 Allo-HSCT 后 AML 疾病复发的累积发生率
DOI：
10.3389/fonc.2021.732088
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发表时间：
2021
影响因子：
4.7
通讯作者：
Xu Y
中科院分区：
文献类型：
--
作者：
Zhang T;Bao X;Qiu H;Tang X;Han Y;Fu C;Sun A;Ruan C;Wu D;Chen S;Xu Y
使用靶向外显子组测序，我们研究了332例接受同种异体移植的急性髓性白血病（AML）受试者诊断时的突变与移植结果之间的相关性。共有299例患者（299/332，90.1%）至少有一个致癌点突变。在多变量分析中，移植前疾病状态、移植前微小残留病（MRD）、细胞遗传学风险分类和TP 53和FLT 3-ITD高比率突变是同种异体移植后AML复发的独立风险因素（p < 0.05）。然后构建了累积复发率（CIR）的诺模图，该诺模图整合了多变量模型中的所有预测因子，CIR预测的6、12、18和24个月的一致性指数（C指数）值分别为0.754、0.730、0.715和0.690。此外，校准图显示，在内部验证中，移植后6、12、18和24个月CIR的实际观察结果与诺模图预测结果之间存在良好的一致性。在移植后6、12、18和24个月，积分校准指数（ICI）值分别为0.008、0.055、0.094和0.136。以9.73分为界值，两组患者的2年CIR、无病生存率（DFS）和总生存率（OS）差异有统计学意义（p < 0.05）。总之，我们的研究结果表明，基因突变可以帮助预测接受同种异体移植的AML患者的结果。
Using targeted exome sequencing, we studied correlations between mutations at diagnosis and transplant outcomes in 332 subjects with acute myeloid leukemia (AML) receiving allotransplantation. A total of 299 patients (299/332, 90.1%) had at least one oncogenic point mutation. In multivariable analyses, pretransplant disease status, minimal residual disease (MRD) before transplantation (pre-MRD), cytogenetic risk classification, and TP53 and FLT3-ITD high ratio mutations were independent risk factors for AML recurrence after allotransplantation (p < 0.05). A nomogram for the cumulative incidence of relapse (CIR) that integrated all the predictors in the multivariable model was then constructed, and the concordance index (C-index) values at 6, 12, 18, and 24 months for CIR prediction were 0.754, 0.730, 0.715, and 0.690, respectively. Moreover, calibration plots showed good agreements between the actual observation and the nomogram prediction for the 6, 12, 18, and 24 months posttransplantation CIR in the internal validation. The integrated calibration index (ICI) values were 0.008, 0.055, 0.094, and 0.136 at 6, 12, 18, and 24 months posttransplantation, respectively. With a median cutoff score of 9.73 from the nomogram, all patients could be divided into two groups, and the differences in 2-year CIR, disease-free survival (DFS), and overall survival (OS) between these two groups were significant (p < 0.05). Taken together, the results of our study indicate that gene mutations could help to predict the outcomes of patients with AML receiving allotransplantation.
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影响因子：
64.5
作者：
Welch JS;Ley TJ;Link DC;Miller CA;Larson DE;Koboldt DC;Wartman LD;Lamprecht TL;Liu F;Xia J;Kandoth C;Fulton RS;McLellan MD;Dooling DJ;Wallis JW;Chen K;Harris CC;Schmidt HK;Kalicki-Veizer JM;Lu C;Zhang Q;Lin L;O'Laughlin MD;McMichael JF;Delehaunty KD;Fulton LA;Magrini VJ;McGrath SD;Demeter RT;Vickery TL;Hundal J;Cook LL;Swift GW;Reed JP;Alldredge PA;Wylie TN;Walker JR;Watson MA;Heath SE;Shannon WD;Varghese N;Nagarajan R;Payton JE;Baty JD;Kulkarni S;Klco JM;Tomasson MH;Westervelt P;Walter MJ;Graubert TA;DiPersio JF;Ding L;Mardis ER;Wilson RK
通讯作者：
Wilson RK
影响因子：
20.3
作者：
Armand, Philippe;Kim, Haesook T.;Saber, Wael
通讯作者：
Saber, Wael
影响因子：
11.4
作者：
Versluis, J.;Labopin, M.;Mohty, M.
通讯作者：
Mohty, M.
基于下一代测序的急性髓系白血病移植后监测可识别复发风险高的患者
影响因子：
20.3
作者：
Kim, TaeHyung;Moon, Joon Ho;Kim, Dennis Dong Hwan
通讯作者：
Kim, Dennis Dong Hwan
影响因子：
6.2
作者：
Gratwohl, Alois;Stern, Martin;Niederwieser, Dietger
通讯作者：
Niederwieser, Dietger