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Title: Personalized prediction of overall survival in patients with AML in non‐complete remission undergoing allo‐HCT
Authors: Hirabayashi, Shigeki
Uozumi, Ryuji  KAKEN_id  orcid https://orcid.org/0000-0002-9546-9869 (unconfirmed)
Kondo, Tadakazu
Arai, Yasuyuki  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-9662-5093 (unconfirmed)
Kawata, Takahito
Uchida, Naoyuki
Marumo, Atsushi
Ikegame, Kazuhiro
Fukuda, Takahiro
Eto, Tetsuya
Tanaka, Masatsugu
Wake, Atsushi
Kanda, Junya  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-6704-3633 (unconfirmed)
Kimura, Takafumi
Tabuchi, Ken
Ichinohe, Tatsuo
Atsuta, Yoshiko
Yanada, Masamitsu
Yano, Shingo
Author's alias: 平林, 茂樹
魚住, 龍史
近藤, 忠一
新井, 康之
河田, 岳人
諫田, 淳也
Keywords: acute myeloid leukemia
hematopoietic stem cell transplantation
nomogram
non-complete remission
web application
Issue Date: Jun-2021
Publisher: Wiley
Journal title: Cancer Medicine
Volume: 10
Issue: 13
Start page: 4250
End page: 4268
Abstract: Allogenic hematopoietic stem cell transplantation (allo-HCT) is the standard treatment for acute myeloid leukemia (AML) in non-complete remission (non-CR); however, the prognosis is inconsistent. This study aimed to develop and validate nomograms and a web application to predict the overall survival (OS) of patients with non-CR AML undergoing allo-HCT (cord blood transplantation [CBT], bone marrow transplantation [BMT], and peripheral blood stem cell transplantation [PBSCT]). Data from 3052 patients were analyzed to construct and validate the prognostic models. The common significant prognostic factors among patients undergoing allo-HCT were age, performance status, percentage of peripheral blasts, cytogenetic risk, chemotherapy response, and number of transplantations. The conditioning regimen was a significant prognostic factor only in patients undergoing CBT. Compared with cyclophosphamide/total body irradiation, a conditioning regimen of ≥3 drugs, including fludarabine, with CBT exhibited the lowest hazard ratio for mortality (0.384; 95% CI, 0.266-0.554; p < 0.0001). A conditioning regimen of ≥3 drugs with CBT also showed the best leukemia-free survival among all conditioning regimens. Based on the results of the multivariable analysis, we developed prognostic models showing adequate calibration and discrimination (the c-indices for CBT, BMT, and PBSCT were 0.648, 0.600, and 0.658, respectively). Our prognostic models can help in assessing individual risks and designing future clinical studies. Furthermore, our study indicates the effectiveness of multi-drug conditioning regimens in patients undergoing CBT.
Rights: © 2021 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
URI: http://hdl.handle.net/2433/276997
DOI(Published Version): 10.1002/cam4.3920
PubMed ID: 34132501
Appears in Collections:Journal Articles

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