Individual outcome prediction for myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia from MDS after allogeneic hematopoietic cell transplantation
Standard
Individual outcome prediction for myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia from MDS after allogeneic hematopoietic cell transplantation. / Heuser, Michael; Gabdoulline, Razif; Löffeld, Patrick; Dobbernack, Vera; Kreimeyer, Henriette; Pankratz, Mira; Flintrop, Madita; Liebich, Alessandro; Klesse, Sabrina; Panagiota, Victoria; Stadler, Michael; Wichmann, Martin; Shahswar, Rabia; Platzbecker, Uwe; Thiede, Christian; Schroeder, Thomas; Kobbe, Guido; Geffers, Robert; Schlegelberger, Brigitte; Göhring, Gudrun; Kreipe, Hans-Heinrich; Germing, Ulrich; Ganser, Arnold; Kröger, Nicolaus; Koenecke, Christian; Thol, Felicitas.
In: ANN HEMATOL, Vol. 96, No. 8, 08.2017, p. 1361-1372.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - Individual outcome prediction for myelodysplastic syndrome (MDS) and secondary acute myeloid leukemia from MDS after allogeneic hematopoietic cell transplantation
AU - Heuser, Michael
AU - Gabdoulline, Razif
AU - Löffeld, Patrick
AU - Dobbernack, Vera
AU - Kreimeyer, Henriette
AU - Pankratz, Mira
AU - Flintrop, Madita
AU - Liebich, Alessandro
AU - Klesse, Sabrina
AU - Panagiota, Victoria
AU - Stadler, Michael
AU - Wichmann, Martin
AU - Shahswar, Rabia
AU - Platzbecker, Uwe
AU - Thiede, Christian
AU - Schroeder, Thomas
AU - Kobbe, Guido
AU - Geffers, Robert
AU - Schlegelberger, Brigitte
AU - Göhring, Gudrun
AU - Kreipe, Hans-Heinrich
AU - Germing, Ulrich
AU - Ganser, Arnold
AU - Kröger, Nicolaus
AU - Koenecke, Christian
AU - Thol, Felicitas
PY - 2017/8
Y1 - 2017/8
N2 - We integrated molecular data with available prognostic factors in patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) for myelodysplastic syndrome (MDS) or secondary acute myeloid leukemia (sAML) from MDS to evaluate their impact on prognosis. Three hundred four patients were sequenced for mutations in 54 genes. We used a Cox multivariate model and competing risk analysis with internal and cross validation to identify factors prognostic of overall survival (OS), cumulative incidence of relapse (CIR), and non-relapse mortality (NRM). In multivariate analysis, mutated NRAS, U2AF1, IDH2, and TP53 and/or a complex karyotype were significant prognostic markers for OS besides age above 60 years, remission status, IPSS-R cytogenetic risk, HCT-CI > 2 and female donor sex. Mutated NRAS, IDH1, EZH2, and TP53 and/or a complex karyotype were genetic aberrations with prognostic impact on CIR. No molecular markers were associated with the risk of NRM. The inclusion of molecular information results in better risk prediction models for OS and CIR when assessed by the Akaike information criterion. Internal cross validation confirmed the robustness of our comprehensive risk model. In summary, we propose to combine molecular, cytogenetic, and patient- and transplantation-associated risk factors into a comprehensive risk model to provide personalized predictions of outcome after alloHCT.
AB - We integrated molecular data with available prognostic factors in patients undergoing allogeneic hematopoietic cell transplantation (alloHCT) for myelodysplastic syndrome (MDS) or secondary acute myeloid leukemia (sAML) from MDS to evaluate their impact on prognosis. Three hundred four patients were sequenced for mutations in 54 genes. We used a Cox multivariate model and competing risk analysis with internal and cross validation to identify factors prognostic of overall survival (OS), cumulative incidence of relapse (CIR), and non-relapse mortality (NRM). In multivariate analysis, mutated NRAS, U2AF1, IDH2, and TP53 and/or a complex karyotype were significant prognostic markers for OS besides age above 60 years, remission status, IPSS-R cytogenetic risk, HCT-CI > 2 and female donor sex. Mutated NRAS, IDH1, EZH2, and TP53 and/or a complex karyotype were genetic aberrations with prognostic impact on CIR. No molecular markers were associated with the risk of NRM. The inclusion of molecular information results in better risk prediction models for OS and CIR when assessed by the Akaike information criterion. Internal cross validation confirmed the robustness of our comprehensive risk model. In summary, we propose to combine molecular, cytogenetic, and patient- and transplantation-associated risk factors into a comprehensive risk model to provide personalized predictions of outcome after alloHCT.
KW - Acute Disease
KW - Adult
KW - Aged
KW - Algorithms
KW - Female
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Leukemia, Myeloid
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Mutation
KW - Myelodysplastic Syndromes
KW - Neoplasms, Second Primary
KW - Outcome Assessment (Health Care)
KW - Precision Medicine
KW - Prognosis
KW - Proportional Hazards Models
KW - Risk Assessment
KW - Risk Factors
KW - Sequence Analysis, DNA
KW - Survival Analysis
KW - Transplantation, Homologous
KW - Young Adult
KW - Journal Article
KW - Multicenter Study
U2 - 10.1007/s00277-017-3027-5
DO - 10.1007/s00277-017-3027-5
M3 - SCORING: Journal article
C2 - 28612220
VL - 96
SP - 1361
EP - 1372
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 8
ER -