Scholarlink

<p>Allogeneic hematopoietic cell transplantation (allo-HCT) can cure acute leukemia, but relapse and non-relapse mortality restrict its success. Existing models focus on single prognostic areas and are not designed to predict leukemia-free survival (LFS), the outcome that best reflects allo-HCT’s curative intent. In this large retrospective cohort of allografted AL patients (<i>N</i> = 24,317), we combined key pre-transplant patient, disease, and treatment factors into a practical holistic H-score to predict post–allo-HCT LFS. Component weights were derived from Cox-regression hazard ratios in a training cohort (<i>N</i> = 19,029). The model was validated in a geographically split testing cohort (N = 4760), with outcomes assessed using Kaplan-Meier analysis and multivariate Cox models. In the overall cohort (<i>N</i> = 24,317), 2-year overall survival and LFS were 64% and 56%, respectively. The H-score stratified patients into four risk groups, with 2-year LFS ranging from 66.2% in the low-risk group to 32.0% in the very high-risk group. The H-score was the strongest independent predictor of LFS (<i>p</i> &lt; 0.0001), outperforming individual indices and offering more refined risk stratification. The H-score was also an independent predictor of overall survival, relapse, and non-relapse mortality. While individual prediction is limited, the H-score aids patient counseling and provides a useful baseline for comparing new transplant treatments.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

A holistic prognostic model for leukemia-free survival after allogeneic transplantation in acute leukemia

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月2日

查看全文
  • Alexandros Spyridonidis,
  • Allain Thibeault Ferhat,
  • Jacques Emmanuel Galimard,
  • Thomas Schroeder,
  • Régis Peffault de Latour,
  • Nicolaus Kröger,
  • Didier Blaise,
  • Matthias Stelljes,
  • Matthias Eder,
  • Tobias Gedde-Dahl,
  • Igor Wolfgang Blau,
  • Ibrahim Yakoub-Agha,
  • Edouard Forcade,
  • Anne Huynh,
  • Francesca Kinsella,
  • Hélène Labussière-Wallet,
  • Jakob Passweg,
  • Robert Zeiser,
  • Mohamed Houhou,
  • Bipin Savani,
  • Roni Shouval,
  • Jurjen Versluis,
  • Mohamad Mohty,
  • Fabio Ciceri,
  • Annalisa Ruggeri

摘要

Allogeneic hematopoietic cell transplantation (allo-HCT) can cure acute leukemia, but relapse and non-relapse mortality restrict its success. Existing models focus on single prognostic areas and are not designed to predict leukemia-free survival (LFS), the outcome that best reflects allo-HCT’s curative intent. In this large retrospective cohort of allografted AL patients (N = 24,317), we combined key pre-transplant patient, disease, and treatment factors into a practical holistic H-score to predict post–allo-HCT LFS. Component weights were derived from Cox-regression hazard ratios in a training cohort (N = 19,029). The model was validated in a geographically split testing cohort (N = 4760), with outcomes assessed using Kaplan-Meier analysis and multivariate Cox models. In the overall cohort (N = 24,317), 2-year overall survival and LFS were 64% and 56%, respectively. The H-score stratified patients into four risk groups, with 2-year LFS ranging from 66.2% in the low-risk group to 32.0% in the very high-risk group. The H-score was the strongest independent predictor of LFS (p < 0.0001), outperforming individual indices and offering more refined risk stratification. The H-score was also an independent predictor of overall survival, relapse, and non-relapse mortality. While individual prediction is limited, the H-score aids patient counseling and provides a useful baseline for comparing new transplant treatments.