A61 PRE-ALLOGENIC STEM CELL TRANSPLANT CLINICAL FACTORS AND THEIR ASSOCIATION WITH CHRONIC GRAFT VERSUS HOST DISEASE - A RISK FACTOR ANALYSIS FOR CHRONIC GVHD PREDICTION
Notice bibliographique
Résumé
Abstract Background Allogeneic stem cell transplant is the only curative treatment for some hematological malignancies but is associated with significant toxicities and morbidities. The main long-term complication that is associated with decreased quality of life is chronic graft versus host disease (cGVHD) which can affect any organ system in the body. When clinicians are faced with the decision of transplanting patients many considerations must be taken into place. Unfortunately, despite counseling patients regarding possible toxicities and morbidities resulting from the allogeneic stem cell transplant including GVHD, we are unable to give accurate risks of cGVHD, especially organ-specific cGVHD, which might otherwise deter patients and clinicians from undertaking the transplant depending on their priorities that determine their quality of life. Aims We sought to ascertain which prognostic factors could predict gastrointestinal (GI)/liver specific cGVHD. Methods We conducted a retrospective case-control study including a consecutive sample of patients from a single specialty clinic from 2012–2017. Patients with biopsy proven GI/liver cGVHD based on pathology or determined by expert opinion reports were classified as cases and patients who underwent allogenic stem cell transplant without GI symptoms or liver enzyme elevations were controls. Data extracted included: age, gender, chemotherapeutics, donor status (related or unrelated), recipient and donor blood type, stem cell dose (x106 cells), complete blood count and differential, and electrolytes. Logistic regression was used to analyze clinical factors associated with GI/liver specific cGVHD. Results Our chart review retrieved 66 patients without GI/liver specific cGVHD and 55 patients that experienced GI/ liver cGVHD. The mean [SD] age of the sample was 50 [14] years and most of the participants in the study were men (59%). The most common cancer was acute myeloid leukemia. Univariate analysis revealed that male gender and stem cell dose were associated with GI/liver cGVHD. After adjusting for potential confounders, history of any acute GVHD demonstrated a statistically significant association with GI/liver cGVHD (adjusted OR [aOR]=2.7; 95% confidence interval=1.0–1.3; p=0.049), while male gender (aOR=2.7; 95% confidence interval=1.2–6.2; p=0.02) and stem cell dose (aOR=1.2; 95% confidence interval=1.0–1.3; p=0.037) remained statistically significant. The combination of these three clinical factors demonstrated fair discrimination (area under the curve=0.69). Other clinical factors were not significantly associated with GI/liver cGVHD. Conclusions Male gender, previous episode of acute GVHD, and stem cell dose were strongly associated with gastrointestinal (GI)/ liver cGVHD among patients who receive allogeneic stem cell transplants. Funding Agencies None
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 | 0,001 | 0,004 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 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 ».