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Impact of a novel prognostic model on allogeneic hematopoietic stem cell transplantation outcomes in patients with CMML

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机构： [1]Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. [2]Department of Hematology, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, China. [3]Department of Hematology, Xiangya Hospital of Central South University, Changsha, China. [4]Department of Hematology, Sichuan Academy of Medical Sciences, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China. [5]Hematology Section, Cancer Center, The First Hospital of Jilin University, Changchun, China. [6]Department of Hematology, Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. [7]Hematology Department, The 960th Hospital of The People's Liberation Army (PLA) Joint Logistics Support Force, Jinan, China. [8]Department of Hematology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. [9]Department of Hematology, Bone Marrow Transplant Center, The First Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China. [10]Department of Hematology, Changhai Hospital, The Naval Medical University, Shanghai, China. [11]Department of Hematology, Zhujiang Hospital of Southern Medical University, Guangzhou, China. [12]Department of Hematology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China. [13]Department of Hematology, Peking University First Hospital, Beijing, China. [14]Xinqiao Hospital, The Third Military Medical University, Chongqing, China. [15]Department of Hematology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. [16]Department of Hematology, Jiangsu Province Hospital, The First Affiliated Hospital With Nanjing Medical University, Nanjing, China. [17]Department of Hematology, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Zhengzhou, China. [18]Department of Hematology, School of First Affiliated Hospital of Shandong First Medical University, Shandong Province Qianfoshan Hospital, Jinan, China. [19]Department of Hematology, West China Hospital, Sichuan University, Chengdu, China. [20]Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. [21]Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. [22]Department of Hematology, The Second Affiliated Hospital (Tangdu Hospital) of Air Force Medical University, Xi'an, China. [23]Department of Hematology, Western Theater General Hospital of the People's Liberation Army of China, Chengdu, China. [24]Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, China. [25]Department of Hematology, The Third Xiangya Hospital of Central South University, Changsha, China. [26]Department of Hematology, Qilu Hospital, Shandong University, Jinan, China. [27]Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, China.

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Chronic myelomonocytic leukemia (CMML) is a clonal hematopoietic stem cell malignancy, and allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only curable treatment. The outcomes after transplant are influenced by both disease characteristics and patient comorbidities. To develop a novel prognostic model to predict the post-transplant survival of CMML patients, we identified risk factors by applying univariable and multivariable Cox proportional hazards regression to a derivation cohort. In multivariable analysis, advanced age (hazard ratio [HR] 3.583), leukocyte count (HR 3.499), anemia (HR 3.439), bone marrow blast cell count (HR 2.095), and no chronic graft versus host disease (cGVHD; HR 4.799) were independently associated with worse survival. A novel prognostic model termed ABLAG (Age, Blast, Leukocyte, Anemia, cGVHD) was developed and the points were assigned according to the regression equation. The patients were categorized into low risk (0-1), intermediate risk (2, 3), and high risk (4-6) three groups and the 3-year overall survival (OS) were 93.3% (95%CI, 61%-99%), 78.9% (95%CI, 60%-90%), and 51.6% (95%CI, 32%-68%; p < .001), respectively. In internal and external validation cohort, the area under the receiver operating characteristic (ROC) curves of the ABLAG model were 0.829 (95% CI, 0.776-0.902) and 0.749 (95% CI, 0.684-0.854). Compared with existing models designed for the nontransplant setting, calibration plots, and decision curve analysis showed that the ABLAG model revealed a high consistency between predicted and observed outcomes and patients could benefit from this model. In conclusion, combining disease and patient characteristic, the ABLAG model provides better survival stratification for CMML patients receiving allo-HSCT.© 2023 Wiley Periodicals LLC.

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出版当年[2023]版：

大类 | 1 区

医学

小类 | 2 区血液学

最新[2023]版：

大类 | 1 区

医学

小类 | 2 区血液学

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出版当年[2023]版：

Q1 HEMATOLOGY

最新[2023]版：

Q1 HEMATOLOGY

影响因子： 10.1 最新[2023版] 10.1 最新五年平均 10.1 出版当年[2023版] 10.1 出版当年五年平均 12.8 出版前一年[2022版]

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第一作者机构： [1]Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China.

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通讯作者：

通讯机构： [1]Peking University People's Hospital, Peking University Institute of Hematology, National Clinical Research Center for Hematologic Disease, Beijing Key Laboratory of Hematopoietic Stem Cell Transplantation, Beijing, China. [*1]No. 11 Xizhimen South St, Xicheng District, Beijing 100044, China.

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