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. 2022 May 3;11(1):25.
doi: 10.1186/s40164-022-00278-x.

A comprehensive model to predict severe acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation

Meng-Zhu Shen #  1 , Shen-Da Hong #  2 , Rui Lou #  1 , Rui-Ze Chen #  1   3 , Xiao-Hui Zhang  1 , Lan-Ping Xu  1 , Yu Wang  1 , Chen-Hua Yan  1 , Huan Chen  1 , Yu-Hong Chen  1 , Wei Han  1 , Feng-Rong Wang  1 , Jing-Zhi Wang  1 , Kai-Yan Liu  1 , Xiao-Jun Huang  1   4   5 , Xiao-Dong Mo  6   7
Affiliations

A comprehensive model to predict severe acute graft-versus-host disease in acute leukemia patients after haploidentical hematopoietic stem cell transplantation

Meng-Zhu Shen et al. Exp Hematol Oncol. .

Abstract

Background: Acute graft-versus-host disease (aGVHD) remains the major cause of early mortality after haploidentical related donor (HID) hematopoietic stem cell transplantation (HSCT). We aimed to establish a comprehensive model which could predict severe aGVHD after HID HSCT.

Methods: Consecutive 470 acute leukemia patients receiving HID HSCT according to the protocol registered at https://clinicaltrials.gov (NCT03756675) were enrolled, 70% of them (n = 335) were randomly selected as training cohort and the remains 30% (n = 135) were used as validation cohort.

Results: The equation was as follows: Probability (grade III-IV aGVHD) = [Formula: see text], where Y = -0.0288 × (age) + 0.7965 × (gender) + 0.8371 × (CD3 + /CD14 + cells ratio in graft) + 0.5829 × (donor/recipient relation) - 0.0089 × (CD8 + cell counts in graft) - 2.9046. The threshold of probability was 0.057392 which helped separate patients into high- and low-risk groups. The 100-day cumulative incidence of grade III-IV aGVHD in the low- and high-risk groups was 4.1% (95% CI 1.9-6.3%) versus 12.8% (95% CI 7.4-18.2%) (P = 0.001), 3.2% (95% CI 1.2-5.1%) versus 10.6% (95% CI 4.7-16.5%) (P = 0.006), and 6.1% (95% CI 1.3-10.9%) versus 19.4% (95% CI 6.3-32.5%) (P = 0.017), respectively, in total, training, and validation cohort. The rates of grade III-IV skin and gut aGVHD in high-risk group were both significantly higher than those of low-risk group. This model could also predict grade II-IV and grade I-IV aGVHD.

Conclusions: We established a model which could predict the development of severe aGVHD in HID HSCT recipients.

Keywords: Acute graft-versus-host disease; Acute leukemia; Haploidentical donor; Hematopoietic stem cell transplant; Predicted model.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flow diagram of building machine learning model
Fig. 2
Fig. 2
ROC curve and confusion matrix for grade III to IV aGVHD model in the training (A) and validation cohort (B)
Fig. 3
Fig. 3
The 100-day cumulative incidence of grade III to IV aGVHD in the low- and high-risk groups in total (A), training (B), and validation (C) cohort, and D the rates of grade III to IV aGVHD of each organ in the low- and high-risk group
Fig. 4
Fig. 4
The association between predicted model and other GVHD endpoint in total population. A The 100-day cumulative incidence of grade II to IV aGVHD in the low- and high-risk groups; B The rate of grade II to IV aGVHD of each organ in the low- and high-risk groups; C The 100-day cumulative incidence of grade I–IV aGVHD in the low- and high-risk groups; D The rate of grade I to IV aGVHD of each organ in the low- and high-risk groups
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References

    1. Zhang XH, Chen J, Han MZ, Huang H, Jiang EL, Jiang M, et al. The consensus from The Chinese Society of Hematology on indications, conditioning regimens and donor selection for allogeneic hematopoietic stem cell transplantation: 2021 update. J Hematol Oncol. 2021;14(1):145. doi: 10.1186/s13045-021-01159-2. - DOI - PMC - PubMed
    1. Xu L, Chen H, Chen J, Han M, Huang H, Lai Y, et al. The consensus on indications, conditioning regimen, and donor selection of allogeneic hematopoietic cell transplantation for hematological diseases in China-recommendations from the Chinese Society of Hematology. J Hematol Oncol. 2018;11(1):33. doi: 10.1186/s13045-018-0564-x. - DOI - PMC - PubMed
    1. Passweg JR, Baldomero H, Chabannon C, Basak GW, de la Cámara R, Corbacioglu S, et al. Hematopoietic cell transplantation and cellular therapy survey of the EBMT: monitoring of activities and trends over 30 years. Bone Marrow Transplant. 2021;56(7):1651–1664. doi: 10.1038/s41409-021-01227-8. - DOI - PMC - PubMed
    1. Xu LP, Lu PH, Wu DP, Sun ZM, Liu QF, Han MZ, et al. Hematopoietic stem cell transplantation activity in China 2019: a report from the Chinese Blood and Marrow Transplantation Registry Group. Bone Marrow Transplant. 2021;56(12):2940–2947. doi: 10.1038/s41409-021-01431-6. - DOI - PMC - PubMed
    1. Ringdén O, Labopin M, Sadeghi B, Mailhol A, Beelen D, Fløisand Y, et al. What is the outcome in patients with acute leukaemia who survive severe acute graft-versus-host disease? J Intern Med. 2018;283(2):166–177. doi: 10.1111/joim.12695. - DOI - PubMed

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