Data-driven grading of acute graft-versus-host disease
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Data-driven grading of acute graft-versus-host disease. / Bayraktar, Evren; Graf, Theresa; Ayuk, Francis A; Beutel, Gernot; Penack, Olaf; Luft, Thomas; Brueder, Nicole; Castellani, Gastone; Reinhardt, H Christian; Kröger, Nicolaus; Beelen, Dietrich W; Turki, Amin T.
In: NAT COMMUN, Vol. 14, No. 1, 28.11.2023, p. 7799.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Data-driven grading of acute graft-versus-host disease
AU - Bayraktar, Evren
AU - Graf, Theresa
AU - Ayuk, Francis A
AU - Beutel, Gernot
AU - Penack, Olaf
AU - Luft, Thomas
AU - Brueder, Nicole
AU - Castellani, Gastone
AU - Reinhardt, H Christian
AU - Kröger, Nicolaus
AU - Beelen, Dietrich W
AU - Turki, Amin T
N1 - © 2023. The Author(s).
PY - 2023/11/28
Y1 - 2023/11/28
N2 - Despite advances in allogeneic hematopoietic cell transplantation, acute graft-versus-host disease (aGVHD) remains its leading complication, yet with heterogeneous outcomes. Here, we analyzed aGVHD phenotypes and clinical classifications in depth in large, multicenter cohorts involving 3019 patients and addressed prevailing gaps by developing data-driven models. We compared, tested and verified these along with all conventional classifications in independent cohorts and found that data-driven grading outperformed conventional grading in Akaike information criterion and concordance index metrics. Data-driven classifications refined aGVHD assessment with up to 12 severity grades, which were associated with distinct nonrelapse mortality (NRM) and confirmed the key role of intestinal aGVHD. We developed an online calculator for physicians to implement principal component-derived grading (PC1). These results provide substantial insight into the evaluation of aGVHD phenotypes and multiorgan involvement, which relegates the exclusive reporting of overall aGVHD severity grades in transplant registries and clinical trials. Data-driven aGVHD grading provides an expandable platform to refine classification and transplant risk assessment.
AB - Despite advances in allogeneic hematopoietic cell transplantation, acute graft-versus-host disease (aGVHD) remains its leading complication, yet with heterogeneous outcomes. Here, we analyzed aGVHD phenotypes and clinical classifications in depth in large, multicenter cohorts involving 3019 patients and addressed prevailing gaps by developing data-driven models. We compared, tested and verified these along with all conventional classifications in independent cohorts and found that data-driven grading outperformed conventional grading in Akaike information criterion and concordance index metrics. Data-driven classifications refined aGVHD assessment with up to 12 severity grades, which were associated with distinct nonrelapse mortality (NRM) and confirmed the key role of intestinal aGVHD. We developed an online calculator for physicians to implement principal component-derived grading (PC1). These results provide substantial insight into the evaluation of aGVHD phenotypes and multiorgan involvement, which relegates the exclusive reporting of overall aGVHD severity grades in transplant registries and clinical trials. Data-driven aGVHD grading provides an expandable platform to refine classification and transplant risk assessment.
KW - Humans
KW - Acute Disease
KW - Graft vs Host Disease/diagnosis
KW - Hematopoietic Stem Cell Transplantation/adverse effects
KW - Risk Assessment
KW - Transplants
KW - Retrospective Studies
U2 - 10.1038/s41467-023-43372-2
DO - 10.1038/s41467-023-43372-2
M3 - SCORING: Journal article
C2 - 38017035
VL - 14
SP - 7799
JO - NAT COMMUN
JF - NAT COMMUN
SN - 2041-1723
IS - 1
ER -
