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A predictive model for therapy failure in chronic myeloid leukemia patients receiving tyrosine kinase inhibitor therapy

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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]National Clinical Research Center for Blood Diseases, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjing, China. [3]Department of Hematology, The First Affiliated Hospital of Zhejiang University, College of Medicine, Zhejiang University. Department of Hematology, The Fourth Affiliated Hospital of Zhejiang University, College of Medicine, Zhejiang University. Zhejiang Provincial Clinical Research Center for Hematological Disorders, Zhejiang, China. [4]Department of Hematology, Henan Cancer Hospital, The Affiliated Cancer Hospital of Zhengzhou University, Henan, China. [5]Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou, China. [6]Centre for Hematology, Department of Immunology and Inflammation, Imperial College London, London, UK. [7]Department of Hematology, Union hospital, Tongji Medical college, Huazhong University of Science and Technology, Wuhan, China. [8]Department of Hematology, Institute of Hematology, West China Hospital,Sichuan University, Sichuan, China. [9]Department of Hematology, the First Hospital of Jilin University, Jilin, China. [10]Department of Hematology, The Second People’s Hospital of Shenzhen, The First Affiliated Hospital of Shenzhen University, Shenzhen, China. [11]Department of Hematology, Xijing Hospital, Airforce Military Medical University, Xi’an, China. [12]Department of Hematology, Qilu Hospital of Shandong University, Jinan, China. [13]Department of Hematology, Sichuan Academy of Medical Sciences Sichuan Provincial People’s Hospital, Sichuan, China. [14]Department of Hematology, Xi’an international medical center hospital, Xi’an, China. [15]Department of Hematology, Shengjing Hospital of China Medical University, Shenyang, China. [16]Department of Hematology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China. [17]Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Guangxi, China. [18]Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Fujian, China. [19]Center of Hematology, The First Affiliated Hospital of Nanchang University, Nanchang, China. [20]Department of Hematology, Tongji Hospital of Tongji Medical College, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China. [21]Department of Hematology, The Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China. [22]Department of Hematology, Hainan General Hospital, Hainan, China. [23]Department of Hematology, Shenzhen Baoan Hospital, Shenzhen University Second Affiliated Hospital, Shenzhen, China. [24]Department of Hematology, Henan Provincial People’s Hospital [26]Zhengzhou University People’s Hospital, Henan, China. [25]Department of Hematology, the Second Hospital Affiliated to Kunming Medical University, Kunming, China. [26]National Clinical Research Center for Hematologic Diseases, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, Institute of Blood and Marrow Transplantation of Soochow University, Soochow, China. [27]Department of Hematology, The First Affiliated Hospital of Dalian Medical University, Dalian, China. [28]Department of Hematology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. [29]Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics, National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China. [30]Department of Hematology, Huazhong University of Science and Technology Union Shenzhen Hospital, Nanshan Hospital, Shenzhen, China. [31]Department of Hematology, The Second Affiliated Hospital of Fujian Medical University, Fujian, China. [32]Department of Hematology, Peking University Shenzhen Hospital, Shenzhen, China. [33]Department of Hematology, The First Affiliated Hospital of Anhui Medical University, Anhui, China. [34]Department of Hematology, Handan Central Hospital, Handan, China. [35]Department of Hematology, First Hospital of Shanxi Medical University, Shanxi, China. [36]Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China. [37]State Key Laboratory of Natural and Biomimetic Drugs, Peking University, Beijing, China. [38]Peking University People’s Hospital, Qingdao, China.
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关键词: predictive model therapy failure chronic myeloid leukemia tyrosine kinase-inhibitor

摘要:
Although tyrosine kinase inhibitor (TKI) therapy has markedly improved the survival of people with chronic-phase chronic myeloid leukemia (CML), 20-30% of people still experienced therapy failure. Data from 1,955 consecutive subjects with chronic-phase CML diagnosed by the European LeukemiaNet (ELN) recommendations from 1 center receiving initial TKI imatinib or a second-generation (2G-) TKI therapy were interrogated to develop a clinical prediction model for TKI therapy failure. This model was subsequently validated in 3,454 subjects from 76 other centers. Using the predictive clinical co-variates associated with TKI therapy failure, we developed a model that stratified subjects into low-, intermediate- and high-risk subgroups with significantly different cumulative incidences of therapy failure (p < 0.001). There was good discrimination and calibration in the external validation dataset, and the performance was consistent with that of the training dataset. Our model had the better prediction discrimination than the Sokal and ELTS scores did, with the greater time-dependent area under the receiver-operator characteristic curve (AUROC) values and a better ability to re-defined the risk of therapy failure. Our model could help physicians estimate the likelihood of initial imatinib or 2G-TKI therapy failure in people with chronic-phase CML.Copyright © 2024 American Society of Hematology.

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出版当年[2023]版:
大类 | 1 区 医学
小类 | 1 区 血液学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 血液学
第一作者:
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. [36]Peking-Tsinghua Center for Life Sciences, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China. [37]State Key Laboratory of Natural and Biomimetic Drugs, Peking University, Beijing, China. [38]Peking University People’s Hospital, Qingdao, China.
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