Using T-lymphocyte subsets at engraftment to predict the risk of acute graft-versus-host disease in patients with thalassemia major: development of a new predictive nomogram.

IF 3.4 3区 医学 Q2 HEMATOLOGY
Therapeutic Advances in Hematology Pub Date : 2024-12-10 eCollection Date: 2024-01-01 DOI:10.1177/20406207241294054
Hongwen Xiao, Gaohui Yang, Qiulin Huang, Zhenbin Wei, Zhaoping Gan, Meiqing Wu, Zeyan Shi, Huicheng Huang, Zhaofang Pan, Lianjin Liu, Lingling Shi, Zhongming Zhang, Rongrong Liu, Yongrong Lai
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引用次数: 0

Abstract

Background: Acute graft-versus-host disease (aGvHD) is the primary cause of mortality following allogeneic hematopoietic cell transplantation (HCT).

Objectives: This study aimed to predict the risk of aGvHD after HCT in patients with thalassemia major using a novel predictive nomogram.

Design: A retrospective study was used to develop the prediction model.

Methods: We performed retrospective analyses on 402 consecutive thalassemia patients who underwent HCT. Risk factors for aGvHD were analyzed using Cox proportional regression models. T-lymphocyte subsets were collected from 240 patients at the time of neutrophil engraftment. Least Absolute Shrinkage and Selection Operator regression was utilized to screen the indices, with cut-off values established through restricted cubic spline (RCS) regression. The predictive model was developed by integrating these T-lymphocyte subsets with clinical features, aiming to enhance the accuracy of aGvHD risk prediction.

Results: Among 402 thalassemia patients analyzed post-transplantation, significant independent risk factors for aGvHD included matched unrelated donors, haploid-related donors, peripheral blood stem cell infusions, and donor age older than 40 years. Our RCS analysis indicated a marked increase in aGvHD risk when CD4+ T-cell counts exceeded 36 cells/μL and CD8+ T-cell counts exceeded 43 cells/μL during neutrophil engraftment. The integration of T-lymphocyte subsets with clinical risk factors into a Cox regression model demonstrated good predictive performance for assessing aGvHD risk.

Conclusion: This study presents a novel model designed to predict aGvHD in thalassemia patients post-transplantation by utilizing T-lymphocyte data at the time of engraftment. The model facilitates the creation of personalized treatment plans, aiming to minimize the incidence of aGvHD and improve patient outcomes.

在移植时使用t淋巴细胞亚群来预测重度地中海贫血患者急性移植物抗宿主病的风险:一种新的预测nomogram
背景:急性移植物抗宿主病(aGvHD)是异基因造血细胞移植(HCT)后死亡的主要原因。目的:本研究旨在利用一种新的预测图预测重度地中海贫血患者HCT后发生aGvHD的风险。设计:采用回顾性研究建立预测模型。方法:我们对402例连续接受HCT治疗的地中海贫血患者进行回顾性分析。采用Cox比例回归模型分析aGvHD的危险因素。收集240例患者在植入中性粒细胞时的t淋巴细胞亚群。使用最小绝对收缩和选择算子回归筛选指标,并通过限制三次样条(RCS)回归确定截止值。将这些t淋巴细胞亚群与临床特征相结合,建立预测模型,旨在提高aGvHD风险预测的准确性。结果:在402例移植后地中海贫血患者中,aGvHD的重要独立危险因素包括匹配的非亲属供体、单倍体相关供体、外周血干细胞输注和供体年龄大于40岁。我们的RCS分析表明,在中性粒细胞植入期间,当CD4+ t细胞计数超过36个细胞/μL和CD8+ t细胞计数超过43个细胞/μL时,aGvHD的风险显著增加。将t淋巴细胞亚群与临床危险因素整合到Cox回归模型中,对评估aGvHD风险具有良好的预测性能。结论:本研究提出了一种利用移植时t淋巴细胞数据预测地中海贫血患者移植后aGvHD的新模型。该模型有助于制定个性化的治疗计划,旨在最大限度地减少aGvHD的发生率并改善患者的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
54
审稿时长
7 weeks
期刊介绍: Therapeutic Advances in Hematology delivers the highest quality peer-reviewed articles, reviews, and scholarly comment on pioneering efforts and innovative studies across all areas of hematology. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in hematology, providing a forum in print and online for publishing the highest quality articles in this area.
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