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Title: Pre-transplant ferritin, albumin and haemoglobin are predictive of survival outcome independent of disease risk index following allogeneic stem cell transplantation.
Austin Authors: Chee, L;Tacey, M;Lim, B;Lim, Andrew;Szer, J;Ritchie, D
Affiliation: Department of Clinical Haematology and Bone Marrow Transplant Service, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Medicine, The University of Melbourne, Parkville, Victoria, Australia
Melbourne EpiCentre, The Royal Melbourne Hospital, Parkville, Victoria, Australia
Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
Department of Clinical Haematology, Austin Health, Heidelberg, Victoria, Australia
Australian Cancer Research Foundation (ACRF) Translational Laboratory, Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
Issue Date: Jun-2017 2017-05-17
Publication information: Bone marrow transplantation 2017; 52(6): 870-877
Abstract: Prognostic biomarkers are useful in allogeneic stem cell transplantation (SCT) to predict survival and relapse outcomes. We sought to derive a prognostic scoring system, which augmented the predictive power of the disease risk index (DRI) by incorporating biomarkers and validating their significance after SCT. The outcomes of overall survival (OS) and relapse were assessed with non-relapse mortality (NRM) treated as a competing risk to relapse. Six hundred and two patients were identified through a retrospective analysis of allogeneic SCT recipients for haematological malignancy between 2000 and 2013 in a single centre. Multivariate analysis confirmed the significant predictors of OS pre-SCT were serum ferritin >1000 μg/L (hazard ratio (HR) 1.94, 95% comorbidity index (CI): 1.44-2.60), Hb <100 g/L (HR 1.71, 95% CI: 1.27-2.30) and albumin <30 g/L (HR 2.65, 95% CI: 1.30-5.40). In combination with DRI, these biomarkers significantly improved the Harrell's C statistic (excluding biomarkers: C=0.60, 95% CI: 0.57-0.64; with biomarkers: C=0.65, 95% CI: 0.62-0.69, P<0.001). Four prognostic groups were derived at the pre-SCT time point: Group 1 (Scores 0-1, n=180, HR=1 (ref)), Group 2 (Scores 2-5, n=298, HR 2.7, 95% CI: 1.8-3.9), Group 3 (Scores 6-7, n=87, HR 4.5, 95% CI: 3.0-6.9) and Group 4 (scores 8-10, n=9, HR 13.4, 95% CI: 5.9-30.2). These prognostic models were also predictive of relapse and NRM and remained valid at day 100, 12 months and 24 months post SCT.
DOI: 10.1038/bmt.2017.51
ORCID: 0000-0001-6783-2301
PubMed URL: 28504664
Type: Journal Article
Appears in Collections:Journal articles

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