Predicting mortality from intracranial hemorrhage in patients who undergo allogeneic hematopoietic stem cell transplantation

被引：4

作者：

Ren, Xiying ^{[1
,2
,3
,4
]}

Huang, Qiusha ^{[1
,2
,3
,4
]}

Qu, Qingyuan ^{[1
,2
,3
,4
]}

Cai, Xuan ^{[1
,2
,3
,4
]}

Fu, Haixia ^{[1
,2
,3
,4
]}

Mo, Xiaodong ^{[1
,2
,3
,4
]}

Wang, Yu ^{[1
,2
,3
,4
]}

Zheng, Yawei ^{[5
,6
]}

Jiang, Erlie ^{[5
,6
]}

Ye, Yishan ^{[7
]}

Luo, Yi ^{[7
]}

Chen, Shaozhen ^{[8
]}

Yang, Ting ^{[8
]}

Zhang, Yuanyuan ^{[1
,2
,3
,4
]}

Han, Wei ^{[1
,2
,3
,4
]}

Tang, Feifei ^{[1
,2
,3
,4
]}

Mo, Wenjian ^{[9
]}

Wang, Shunqing ^{[9
]}

Li, Fei ^{[10
]}

Liu, Daihong ^{[10
]}

Zhang, Xiaoying ^{[11
]}

Zhang, Yicheng ^{[11
]}

Feng, Shuqing ^{[12
]}

Gao, Feng ^{[12
]}

Yuan, Hailong ^{[13
]}

Wang, Dao ^{[14
]}

Wan, Dingming ^{[15
]}

Chen, Huan ^{[1
,2
,3
,4
]}

Chen, Yao ^{[1
,2
,3
,4
]}

Wang, Jingzhi ^{[1
,2
,3
,4
]}

Chen, Yuhong ^{[1
,2
,3
,4
]}

Wang, Ying ^{[16
]}

Xu, Kailin ^{[16
]}

Lang, Tao ^{[17
]}

Wang, Xiaomin ^{[17
]}

Meng, Hongbin ^{[18
]}

Li, Limin ^{[18
]}

Wang, Zhiguo ^{[19
]}

Fan, Yanling ^{[19
]}

Chang, Yingjun ^{[1
,2
,3
,4
]}

Xu, Lanping ^{[1
,2
,3
,4
]}

Huang, Xiaojun ^{[1
,2
,3
,4
]}

Zhang, Xiaohui ^{[1
,2
,3
,4
]}

机构：

[1] Peking Univ Peoples Hosp, Peking Univ Inst Hematol, Beijing, Peoples R China

[2] Beijing Key Lab Hematopoiet Stem Cell Transplanta, Beijing, Peoples R China

[3] Peking Univ, Collaborat Innovat Ctr Hematol, Beijing, Peoples R China

[4] Natl Clin Res Ctr Hematol Dis, Beijing, Peoples R China

[5] Chinese Acad Med Sci & Peking Union Med Coll, Inst Hematol, Ctr Hematopoiet Stem Cell Transplantat, Tianjin, Peoples R China

[6] Chinese Acad Med Sci & Peking Union Med Coll, Blood Dis Hosp, Tianjin, Peoples R China

[7] Zhejiang Univ, Affiliated Hosp 1, Bone Marrow Transplantat Ctr, Sch Med, Hangzhou, Peoples R China

[8] Fujian Med Univ, Fujian Inst Hematol, Dept Hematol, Fujian Prov Key Lab Hematol,Union Hosp, Fuzhou, Peoples R China

[9] South China Univ Technol, Guangzhou Peoples Hosp 1, Sch Med, Dept Hematol, Guangzhou, Peoples R China

[10] Chinese Peoples Liberat Army Gen Hosp, Dept Hematol, Beijing, Peoples R China

[11] Huazhong Univ Sci & Technol, Tongji Hosp, Tongji Med Coll, Dept Hematol, Wuhan, Peoples R China

[12] North China Univ Sci & Technol, Dept Hematol, Affiliated Hosp, Tangshan, Peoples R China

[13] Xinjiang Med Univ, Hematol Ctr, Affiliated Hosp 1, Urumqi, Peoples R China

[14] Zhengzhou Univ, Affiliated Hosp 1, Dept Pediat, Zhengzhou, Peoples R China

[15] Zhengzhou Univ, Dept Hematol, Affiliated Hosp 1, Zhengzhou, Peoples R China

[16] Xuzhou Med Univ, Dept Hematol, Affiliated Hosp, Xuzhou, Jiangsu, Peoples R China

[17] Peoples Hosp Xinjiang Uygur Autonomous Reg, Dept Hematol, Urumqi, Peoples R China

[18] Harbin Med Univ, Affiliated Hosp 1, Dept Hematol, Harbin, Peoples R China

[19] Harbin Inst Hematol & Oncol, Bone Marrow Transplantat Dept, Harbin, Peoples R China

来源：

BLOOD ADVANCES | 2021年 / 5卷 / 23期

基金：

中国国家自然科学基金; 北京市自然科学基金;

关键词：

BONE-MARROW-TRANSPLANTATION; INITIAL CONSERVATIVE TREATMENT; MINIMALLY INVASIVE SURGERY; ACTIVATED FACTOR-VII; INTRACEREBRAL HEMORRHAGE; RISK-FACTORS; NEUROLOGIC COMPLICATIONS; EXTERNAL VALIDATION; ICH SCORE; STROKE;

D O I：

10.1182/bloodadvances.2021004349

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Intracranial hemorrhage (ICH) is a rare but fatal central nervous system complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT). However, factors that are predictive of early mortality in patients who develop ICH after undergoing allo-HSCT have not been systemically investigated. From January 2008 to June 2020, a total of 70 allo-HSCT patients with an ICH diagnosis formed the derivation cohort. Forty-one allo-HSCT patients with an ICH diagnosis were collected from 12 other medical centers during the same period, and they cornprised the external validation cohort. These 2 cohorts were used to develop and validate a grading scale that enables the prediction of 30-day mortality from ICH in all-HSCT patients. Four predictors (lactate dehydrogenase level, albumin level, white blood cell count, and disease status) were retained in the multivariable logistic regression model, and a simplified grading scale (termed the LAWS score) was developed. The LAWS score was adequately calibrated (Hosmer-Lemeshow test, P > .05) in both cohorts. It had good discrimination power in both the derivation cohort (C-statistic, 0.859; 95% confidence interval, 0.776-0.945) and the external validation cohort (C-statistic, 0.795; 95% confidence interval, 0.645-0.945). The LAWS score is the first scoring system capable of predicting 30-day mortality from ICH in allo-HSCT patients. It showed good performance in identifying allo-HSCT patients at increased risk of early mortality after ICH diagnosis. We anticipate that it would help risk stratify allo-HSCT patients with ICH and facilitate future studies on developing individualized and novel interventions for patients within different LAWS risk groups.

引用

页码：4910 / 4921

页数：12

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