دورية أكاديمية
Immune Reconstitution-Based Score for Risk Stratification of Chronic Graft-Versus-Host Disease Patients
| العنوان: | Immune Reconstitution-Based Score for Risk Stratification of Chronic Graft-Versus-Host Disease Patients |
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| المؤلفون: | Serpenti F., Lorentino F., Marktel S., Milani R., Messina C., Greco R., Girlanda S., Clerici D., Giglio F., Liberatore C., Farina F., Mastaglio S., Piemontese S., Guggiari E., Lunghi F., Marcatti M., Carrabba M. G., Bernardi M., Bonini C., Assanelli A., Corti C., Peccatori J., Ciceri F., Lupo-Stanghellini M. T. |
| المساهمون: | Serpenti, F., Lorentino, F., Marktel, S., Milani, R., Messina, C., Greco, R., Girlanda, S., Clerici, D., Giglio, F., Liberatore, C., Farina, F., Mastaglio, S., Piemontese, S., Guggiari, E., Lunghi, F., Marcatti, M., Carrabba, M. G., Bernardi, M., Bonini, C., Assanelli, A., Corti, C., Peccatori, J., Ciceri, F., Lupo-Stanghellini, M. T. |
| بيانات النشر: | Frontiers Media S.A. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | biomarker, chronic GvHD, immune reconstitution, overall survival, prognostic score |
| الوصف: | Introduction: Allogeneic stem cell transplantation survivors are at a relevant risk of developing chronic GvHD (cGvHD), which importantly affects quality of life and increases morbidity and mortality. Early identification of patients at risk of cGvHD-related morbidity could represent a relevant tool to tailor preventive strategies. The aim of this study was to evaluate the prognostic power of immune reconstitution (IR) at cGvHD onset through an IR-based score. Methods: We analyzed data from 411 adult patients consecutively transplanted between January 2011 and December 2016 at our Institution: 151 patients developed cGvHD (median follow-up 4 years). A first set of 111 consecutive patients with cGvHD entered the test cohort while an additional consecutive 40 patients represented the validation cohort. A Cox multivariate model for OS (overall survival) in patients with cGvHD of any severity allowed the identification of six variables independently predicting OS and TRM (transplant-related mortality). A formula for a prognostic risk index using the β coefficients derived from the model was designed. Each patient was assigned a score defining three groups of risk (low, intermediate, and high). Results: Our multivariate model defined the variables independently predicting OS at cGvHD onset: CD4+ >233 cells/mm3, NK <115 cells/mm3, IgA <0.43g/L, IgM <0.45g/L, Karnofsky PS <80%, platelets <100x103/mm3. Low-risk patients were defined as having a score ≤3.09, intermediate-risk patients >3.09 and ≤6.9, and high-risk patients >6.9. By ROC analysis, we identified a cut-off of 6.310 for both TRM and overall mortality. In the training cohort, the 6-year OS and TRM from cGvHD occurrence were 85% (95% CI, 70-92) and 13% (95% CI, 5-25) for low-risk, 64% (95% CI, 44-89) and 30% (95% CI, 15-47) for intermediate-risk, 26% (95% CI, 10-47), and 42% (95% CI, 19-63) for high-risk patients (OS p<0.0001; TRM p = 0.015). The validation cohort confirmed the model with a 6-year OS and TRM of 83% (95% CI, 48-96) and ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/wos/WOS:000683805600001; volume:11; firstpage:705568; journal:FRONTIERS IN ONCOLOGY; http://hdl.handle.net/20.500.11768/124221Test; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85112664695 |
| DOI: | 10.3389/fonc.2021.705568 |
| الإتاحة: | https://doi.org/20.500.11768/124221Test https://doi.org/10.3389/fonc.2021.705568Test https://hdl.handle.net/20.500.11768/124221Test |
| رقم الانضمام: | edsbas.88BD5E7C |
| قاعدة البيانات: | BASE |
| DOI: | 10.3389/fonc.2021.705568 |
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