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A Personalized Prediction Model for Outcomes after Allogeneic Hematopoietic Cell Transplant in Patients with Myelodysplastic Syndromes.


ABSTRACT: Allogeneic hematopoietic stem cell transplantation (HCT) remains the only potentially curative option for myelodysplastic syndromes (MDS). Mortality after HCT is high, with deaths related to relapse or transplant-related complications. Thus, identifying patients who may or may not benefit from HCT is clinically important. We identified 1514 patients with MDS enrolled in the Center for International Blood and Marrow Transplant Research Registry and had their peripheral blood samples sequenced for the presence of 129 commonly mutated genes in myeloid malignancies. A random survival forest algorithm was used to build the model, and the accuracy of the proposed model was assessed by concordance index. The median age of the entire cohort was 59 years. The most commonly mutated genes were ASXL1(20%), TP53 (19%), DNMT3A (15%), and TET2 (12%). The algorithm identified the following variables prior to HCT that impacted overall survival: age, TP53 mutations, absolute neutrophils count, cytogenetics per International Prognostic Scoring System-Revised, Karnofsky performance status, conditioning regimen, donor age, WBC count, hemoglobin, diagnosis of therapy-related MDS, peripheral blast percentage, mutations in RAS pathway, JAK2 mutation, number of mutations/sample, ZRSR2, and CUX1 mutations. Different variables impacted the risk of relapse post-transplant. The new model can provide survival probability at different time points that are specific (personalized) for a given patient based on the clinical and mutational variables that are listed above. The outcomes' probability at different time points may aid physicians and patients in their decision regarding HCT.

SUBMITTER: Nazha A 

PROVIDER: S-EPMC7609542 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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A Personalized Prediction Model for Outcomes after Allogeneic Hematopoietic Cell Transplant in Patients with Myelodysplastic Syndromes.

Nazha Aziz A   Hu Zhen-Huan ZH   Wang Tao T   Lindsley R Coleman RC   Abdel-Azim Hisham H   Aljurf Mahmoud M   Bacher Ulrike U   Bashey Asad A   Cahn Jean-Yves JY   Cerny Jan J   Copelan Edward E   DeFilipp Zachariah Z   Diaz Miguel Angel MA   Farhadfar Nosha N   Gadalla Shahinaz M SM   Gale Robert Peter RP   George Biju B   Gergis Usama U   Grunwald Michael R MR   Hamilton Betty B   Hashmi Shahrukh S   Hildebrandt Gerhard C GC   Inamoto Yoshihiro Y   Kalaycio Matt M   Kamble Rammurti T RT   Kharfan-Dabaja Mohamed A MA   Lazarus Hillard M HM   Liesveld Jane L JL   Litzow Mark R MR   Majhail Navneet S NS   Murthy Hemant S HS   Nathan Sunita S   Nishihori Taiga T   Pawarode Attaphol A   Rizzieri David D   Sabloff Mitchell M   Savani Bipin N BN   Schachter Levanto L   Schouten Harry C HC   Seo Sachiko S   Shah Nirav N NN   Solh Melhem M   Valcárcel David D   Vij Ravi R   Warlick Erica E   Wirk Baldeep B   Wood William A WA   Yared Jean A JA   Alyea Edwin E   Popat Uday U   Sobecks Ronald M RM   Scott Bart L BL   Nakamura Ryotaro R   Saber Wael W  

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 20200808 11


Allogeneic hematopoietic stem cell transplantation (HCT) remains the only potentially curative option for myelodysplastic syndromes (MDS). Mortality after HCT is high, with deaths related to relapse or transplant-related complications. Thus, identifying patients who may or may not benefit from HCT is clinically important. We identified 1514 patients with MDS enrolled in the Center for International Blood and Marrow Transplant Research Registry and had their peripheral blood samples sequenced for  ...[more]

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