Serum albumin level predicts survival of patients with gastrointestinal acute graft-versus-host disease after allogeneic stem cell transplantation
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Serum albumin level predicts survival of patients with gastrointestinal acute graft-versus-host disease after allogeneic stem cell transplantation. / Ayuketang, Francis Ayuk; Bussmann, Lara; Zabelina, Tatiana; Veit, Ronja; Alchalby, Haefaa; Wolschke, Christine; Lellek, Heinrich; Bacher, Ulrike; Zander, Axel R; Kröger, Nicolaus.
In: ANN HEMATOL, Vol. 93, No. 5, 01.05.2014, p. 855-61.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Serum albumin level predicts survival of patients with gastrointestinal acute graft-versus-host disease after allogeneic stem cell transplantation
AU - Ayuketang, Francis Ayuk
AU - Bussmann, Lara
AU - Zabelina, Tatiana
AU - Veit, Ronja
AU - Alchalby, Haefaa
AU - Wolschke, Christine
AU - Lellek, Heinrich
AU - Bacher, Ulrike
AU - Zander, Axel R
AU - Kröger, Nicolaus
PY - 2014/5/1
Y1 - 2014/5/1
N2 - In a retrospective single-centre study, we analysed the prognostic impact of factors identifiable at initial diagnosis of acute GVHD (aGVHD). We retrospectively analysed 495 adult patients of whom 308 (62 %) developed acute GVHD (I-IV) and were included in further analysis. Gut aGVHD was diagnosed in 163/308 cases (53 %). Conditioning was myeloablative conditioning (MAC) in 123 (39.9 %) and reduced intensity (RIC) in 185 (60.1 %) patients. Median serum albumin level at diagnosis of aGVHD was 34 g/l, which was used as cut-off for low vs. normal albumin levels. In patients with gut aGVHD, low albumin level at the time of diagnosis of aGVHD was associated with poorer overall survival (OS) which was 52 vs. 67 % at 1 year and 40 vs. 61 % at 3 years, p = 0.015. In patients with only skin aGVHD, 1- and 3-year OS of patients with low vs. normal albumin levels were 72 vs. 72 % and 59 vs. 57 %, respectively, p = 0.69. In multivariate analysis of patients with gut aGVHD, low serum albumin level ≤34 g/l (relative risk (RR) 2.13, p = 0.003), gut aGVHD grades 3-4 (RR 2.70, p = 0.001), RIC (RR 1.84, p = 0.024), matched unrelated donor (RR 1.86, p = 0.18) and mismatched unrelated donor (RR 2.76, p = 0.03) retained negative impact on OS. Subgroup analysis revealed that impact of albumin was restricted to patients with gut aGVHD after RIC. Low serum albumin levels are associated with poorer OS in patients with gut but not skin aGVHD after RIC but not MAC allogeneic stem cell transplantation.
AB - In a retrospective single-centre study, we analysed the prognostic impact of factors identifiable at initial diagnosis of acute GVHD (aGVHD). We retrospectively analysed 495 adult patients of whom 308 (62 %) developed acute GVHD (I-IV) and were included in further analysis. Gut aGVHD was diagnosed in 163/308 cases (53 %). Conditioning was myeloablative conditioning (MAC) in 123 (39.9 %) and reduced intensity (RIC) in 185 (60.1 %) patients. Median serum albumin level at diagnosis of aGVHD was 34 g/l, which was used as cut-off for low vs. normal albumin levels. In patients with gut aGVHD, low albumin level at the time of diagnosis of aGVHD was associated with poorer overall survival (OS) which was 52 vs. 67 % at 1 year and 40 vs. 61 % at 3 years, p = 0.015. In patients with only skin aGVHD, 1- and 3-year OS of patients with low vs. normal albumin levels were 72 vs. 72 % and 59 vs. 57 %, respectively, p = 0.69. In multivariate analysis of patients with gut aGVHD, low serum albumin level ≤34 g/l (relative risk (RR) 2.13, p = 0.003), gut aGVHD grades 3-4 (RR 2.70, p = 0.001), RIC (RR 1.84, p = 0.024), matched unrelated donor (RR 1.86, p = 0.18) and mismatched unrelated donor (RR 2.76, p = 0.03) retained negative impact on OS. Subgroup analysis revealed that impact of albumin was restricted to patients with gut aGVHD after RIC. Low serum albumin levels are associated with poorer OS in patients with gut but not skin aGVHD after RIC but not MAC allogeneic stem cell transplantation.
KW - Acute Disease
KW - Adolescent
KW - Adult
KW - Aged
KW - Biological Markers
KW - Female
KW - Gastrointestinal Tract
KW - Graft vs Host Disease
KW - Hematologic Neoplasms
KW - Hematopoietic Stem Cell Transplantation
KW - Humans
KW - Male
KW - Middle Aged
KW - Multivariate Analysis
KW - Myeloablative Agonists
KW - Prognosis
KW - Retrospective Studies
KW - Serum Albumin
KW - Survival Analysis
KW - Transplantation Conditioning
KW - Transplantation, Homologous
U2 - 10.1007/s00277-013-1957-0
DO - 10.1007/s00277-013-1957-0
M3 - SCORING: Journal article
C2 - 24248672
VL - 93
SP - 855
EP - 861
JO - ANN HEMATOL
JF - ANN HEMATOL
SN - 0939-5555
IS - 5
ER -