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Evaluation of a disease risk index for adult patients undergoing umbilical cord blood transplantation for haematological malignancies
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Personen und Körperschaften: | , , , , , , , , , , , , , , , , , , , |
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Titel: |
Evaluation of a disease risk index for adult patients undergoing umbilical cord blood transplantation for haematological malignancies |
In: | British Journal of Haematology, 179, 2017, 5, S. 790-801 |
veröffentlicht: |
Wiley
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Umfang: | 790-801 |
ISSN: |
0007-1048 1365-2141 |
DOI: | 10.1111/bjh.14962 |
Zusammenfassung: | <jats:title>Summary</jats:title><jats:p>A disease risk index (<jats:styled-content style="fixed-case">DRI</jats:styled-content>) has been defined for stratifying heterogeneous cohorts of patients undergoing allogeneic haematopoietic stem cell transplantation (<jats:styled-content style="fixed-case">HSCT</jats:styled-content>). This index defines 4 distinct groups with different outcomes, dividing patients by disease type and status and considering cytogenetics for acute myeloid leukaemia and myelodysplastic syndromes (<jats:styled-content style="fixed-case">MDS</jats:styled-content>). Recently, the <jats:styled-content style="fixed-case">DRI</jats:styled-content> has been refined to include rare diseases and improve <jats:styled-content style="fixed-case">MDS</jats:styled-content> stratification by blast percentage and response to prior therapy. Previous reports on <jats:styled-content style="fixed-case">DRI</jats:styled-content> include only a small number of <jats:styled-content style="fixed-case">UCBT</jats:styled-content> recipients. The current study aims to determine the applicability of the <jats:styled-content style="fixed-case">DRI</jats:styled-content> for patients undergoing unrelated cord blood transplantation (<jats:styled-content style="fixed-case">UCBT</jats:styled-content>). We retrospectively analysed 2530 adults receiving <jats:styled-content style="fixed-case">UCBT</jats:styled-content> between 2004 and 2014. Diagnosis was acute leukaemia (<jats:styled-content style="fixed-case">AL</jats:styled-content>) in 66% of the cases. Overall survival (<jats:styled-content style="fixed-case">OS</jats:styled-content>) at 2 years was 56 ± 3% for patients with low <jats:styled-content style="fixed-case">DRI</jats:styled-content> (<jats:italic>n</jats:italic> = 352), 46 ± 1% for intermediate <jats:styled-content style="fixed-case">DRI</jats:styled-content> (<jats:italic>n</jats:italic> = 1403), 28 ± 2% for high (<jats:italic>n</jats:italic> = 489) and 20 ± 4% for very high <jats:styled-content style="fixed-case">DRI</jats:styled-content> (<jats:italic>n</jats:italic> = 109) (<jats:italic>P</jats:italic> < 0·001). In the multivariate model, <jats:styled-content style="fixed-case">DRI</jats:styled-content> remained an independent risk factor for <jats:styled-content style="fixed-case">OS</jats:styled-content>. Similar findings were observed for <jats:styled-content style="fixed-case">PFS</jats:styled-content> and <jats:styled-content style="fixed-case">DRI</jats:styled-content>. Our results show the applicability of <jats:styled-content style="fixed-case">DRI</jats:styled-content> for stratifying <jats:styled-content style="fixed-case">UCBT</jats:styled-content> recipients and confirm the prognostic value of this simple and robust tool in this setting.</jats:p> |
Format: | E-Article |
Quelle: | Wiley (CrossRef) |
Sprache: | Englisch |