Risk prediction model of survival after hematopoietic stem cell transplantation in patients with malignant hematological diseases
10.3969/j.issn.1006-2483.2024.02.035
- VernacularTitle:恶性血液病患者行造血干细胞移植后生存情况及风险预测模型
- Author:
Xiaorong HE
1
Author Information
1. Department of Hematology ,West China Hospital , Sichuan University/West China College of Nursing , Sichuan University , Chengdu , Sichuan 610041 , China
- Publication Type:Journal Article
- Keywords:
Hematological malignancies;
Hematopoietic stem cell transplantations;
Survival
- From:
Journal of Public Health and Preventive Medicine
2024;35(2):152-156
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for survival in patients with hematological malignancies after hematopoietic stem cell transplantation (HSCT), to establish a risk prediction and survival prediction model, and to provide a reference for clinical diagnosis and treatment. Methods A total of 237 patients with malignant hematological diseases who underwent HSCT at West China Hospital of Sichuan University from January 2017 to April 2019 were selected as the study subjects. The survival of all patients after HSCT was statistically analyzed. The influencing factors of survival were analyzed by multivariate regression analysis, and the prediction model was constructed. Results A total of 237 patients with hematological malignancies were included in this study. After 3 years of follow-up, 85 patients died, with a mortality rate of 35.86%. Multivariate logistic analysis showed that diabetes mellitus (OR=4.358, P=0.007), infection (OR=3.522, P=0.000), neutropenia time >7d (OR=2.734, P=0.009), incomplete HLA matching (OR=5.688, P=0.000), cGVHD (OR=2.593, P=0.007) and HCT-CI (OR=6.701, P=0.000) were independent risk factors affecting the survival of patients with hematological malignancies after HSCT (P<0.05). The risk prediction model for survival was P=1/(1 + e (3.192 + 01.259 + 1.472 ×(diabetes mellitus) + 1.259×(infection) + 1.006 ×(neutropenia time) + 1.738 ×(HLA matching) + 0.953 ×(cGVHD) + 1.902 ×(HCT-CI)), Hosmer-Lemeshow χ2=6.692, P=0.462. AUC and 95%CI of the model for predicting survival were 0.836 and 0.783-0.888, showing good fit and predictive efficiency. Conclusion Diabetes mellitus, infection, neutropenia time >7d, incomplete HLA matching, cGVHD and HCT-CI are all high-risk factors of survival in patients with malignant hematologic disease after HSCT. Clinically, attentions should be paid to these patients and intervention measures should be taken to improve their survival after HSCT.
