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Preprints

A Comprehensive Model to Predict Severe Acute Graft-Versus-Host Disease after Haploidentical Hematopoietic Stem Cell Transplantation

Shen M, Hong S, Lou R, Chen R, Zhang X, Xu L, Wang Y, Yan C, Chen H, Chen Y, Han W, Wang F, Wang J, Liu K, Huang X, Mo X.
Preprint from
Research Square
11 February 2022
PPR
PPR453077
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) = 1/1 + exp(-Y), 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.