Multi-state analysis illustrates treatment success after stem cell transplantation for acute myeloid leukemia followed by donor lymphocyte infusion

Haematologica
Matthias EeftingJ H Frederik Falkenburg

Abstract

In the field of hematopoietic stem cell transplantation, the common approach is to focus outcome analyses on time to relapse and death, without assessing the impact of post-transplant interventions. We investigated whether a multi-state model would give insight into the events after transplantation in a cohort of patients who were transplanted using a strategy including scheduled donor lymphocyte infusions. Seventy-eight consecutive patients who underwent myeloablative T-cell depleted allogeneic stem cell transplantation for acute myeloid leukemia or myelodysplastic syndrome were studied. We constructed a multi-state model to analyze the impact of donor lymphocyte infusion and graft-versus-host disease on the probabilities of relapse and non-relapse mortality over time. Based on this model we introduced a new measure for outcome after transplantation which we called 'treatment success': being alive without relapse and immunosuppression for graft-versus-host disease. All relevant clinical events were implemented into the multi-state model and were denoted treatment success or failure (either transient or permanent). Both relapse and non-relapse mortality were causes of failure of comparable magnitude. Whereas relapse was the dom...Continue Reading

Citations

Feb 17, 2018·Biometrics·Tobias BluhmkiJan Beyersmann
Mar 8, 2018·Lifetime Data Analysis·Tobias BluhmkiMarkus Pauly
Dec 10, 2017·Hematology·J H Frederik Falkenburg, Inge Jedema
Dec 10, 2017·Hematology·Melanie Grant, Catherine M Bollard
Jan 4, 2018·Blood Advances·Melanie Grant, Catherine M Bollard
Apr 11, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·S Scott SuttonJames W Hardin
Jan 10, 2017·The Journal of Clinical Investigation·Cornelis A M van BergenJ H Frederik Falkenburg
Apr 19, 2018·Inflammatory Bowel Diseases·Parakkal DeepakDavid H Bruining
Oct 25, 2017·Antimicrobial Agents and Chemotherapy·Harriet SommerUNKNOWN COMBACTE-NET and COMBACTE-MAGNET consortium
Oct 28, 2020·American Journal of Hematology·Jean-Baptiste BossardUNKNOWN Société Francophone de Greffe de Moelle et de Thérapie Cellulaire (SFGM-TC), the France-Intergroupe des Syndromes Myéloproli
Jan 14, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Tobias BluhmkiJan Beyersmann
Dec 5, 2017·Blood Reviews·Melanie L Grant, Catherine M Bollard

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