Significant Improvement In Day 100 and 1-Year Overall Survival In Patients Who Underwent Myeloablative Allogeneic Hematopoietic Cell Transplant In the US or Canada Between 1994 and 2005
Notice bibliographique
Résumé
Abstract Abstract 3509 Allogeneic hematopoietic cell transplantation (alloHCT) has become standard therapy for hematologic disorders and malignancies. We assessed whether overall survival (OS) at 100 days, which represents early transplant-related mortality (TRM), and at one year, which represents disease-related mortality and later TRM, had changed over time. The study population was derived from patients undergoing 38,060 first alloHCTs between 1994–2005 in US and Canadian centers and reported to the CIBMTR. Donor lymphocyte infusions were excluded. Statistical significance was measured using Ptrend over 6 time cohorts to test whether the OS estimates were stable (slope = 0), increasing (slope>0) or decreasing (slope<0) over time. The Day 100 and 1 year OS estimates are shown in the Table. Disease and disease status subgroups were defined a priori, and the OS estimates are not adjusted for any covariates such as age, Karnofsky status, etc. Marked improvements in 100-day survival were seen for all disease and disease status groups examined. Day 100 mortality rates in HLA-matched sibling alloHCT recipients during the most recent period (2004-5) were as low as 2% for CML treated in CP1, 6–8% for AML in CR1 and ALL in CR2, and a modest 12% for MDS. Even in alloHCT recipients with unrelated donors treated in 2004-5, the Day 100 mortality rates ranged from 9–22%, a significant decrease from historical mortality rates of 29–37%. Significant improvements in 1-year OS were noted for all groups undergoing unrelated-donor alloHCT; however, among those undergoing HLA-matched sibling alloHCT, significant improvements in 1-year OS were only seen in patients with CML in CP1 or MDS. OS has improved for many patients undergoing myeloablative alloHCT, which likely reflects improvement in supportive care and better patient/donor selection. Day 100 OS has significantly improved in all patients who received a myeloablative HLA-matched related or unrelated donor alloHCT. Significant improvement in 1-year OS was also experienced by most patients. Table: Overall survival (95% CI) estimates over time HLA-Matched Sibling Myeloablative Allogeneic HCT 1994-5 1996-7 1998-9 2000-1 2002-3 2004-5 Ptrend AML in CR1 N 370 370 383 376 384 440 <0.001 @100 days 85 (81–88) 87 (84–90) 90 (86–93) 88 (84–91) 92 (89–94) 94 (91–96) 0.1662 @1 year 69 (65–74) 70 (66–75) 72 (67–76) 67 (62–72) 74 (69–78) 75 (71–80) ALL in CR2+ N 179 186 149 159 156 163 0.0018 @100 days 77 (70–83) 82 (76–87) 88 (82–93) 85 (79–90) 85 (79–90) 92 (87–96) 0.2937 @1 year 62 (55–69) 63 (56–70) 69 (61–77) 59 (51–67) 64 (56–71) 70 (62–77) CML in CP1 N 483 540 492 317 155 125 <0.001 @100 days 84 (81–87) 88 (85–90) 89 (87–92) 91 (87–94) 99 (96–100) 98 (94–100) <0.001 @1 year 71 (66–75) 72 (68–76) 80 (76–83) 82 (77–86) 89 (83–93) 92 (86–96) MDS N 225 290 273 235 239 227 <0.001 @100 days 71 (65–77) 75 (70–80) 76 (71–81) 82 (77–87) 85 (80–89) 88 (84–92) 0.0488 @1 year 54 (48–61) 51 (45–57) 57 (51–63) 58 (51–65) 61 (55–68) 64 (58–71) Unrelated Donor Myeloablative Allogeneic HCT 1994-5 1996-7 1998-9 2000-1 2002-3 2004-5 Ptrend AML in CR1 N 52 75 88 135 182 336 <0.001 @100 days 63 (50–76) 64 (53–74) 69 (59–78) 75 (68–82) 82 (76–87) 86 (82–90) 0.0427 @1 year 48 (35–62) 35 (25–47) 48 (37–59) 51 (42–60) 54 (46–61) 56 (50–62) ALL in CR2+ N 129 151 132 116 164 197 <0.001 @100 days 66 (58–74) 70 (62–77) 71 (62–78) 75 (67–82) 78 (71–84) 91 (87–95) <0.001 @1 year 43 (34–51) 45 (37–53) 49 (40–58) 40 (31–50) 54 (46–62) 67 (60–74) CML in CP1 N 211 250 292 152 87 118 0.0006 @100 days 71 (65–77) 70 (64–75) 74 (69–79) 75 (68–81) 80 (71–88) 87 (81–93) 0.0057 @1 year 51 (44–57) 54 (48–61) 59 (53–64) 60 (52–68) 65 (54–75) 71 (62–80) MDS N 104 138 135 140 161 234 <0.001 @100 days 64 (54–73) 62 (54–70) 59 (51–67) 67 (59–75) 74 (67–81) 78 (72–83) <0.001 @1 year 41 (31–50) 44 (35–52) 35 (27–43) 45 (37–54) 52 (44–60) 57 (50–63) Disclosures: No relevant conflicts of interest to declare.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».