Unrelated donor search prognostic score to support early HLA consultation and clinical decisions
| Autor: | Rachel Fonstad, Kim Wadsworth, S Spellman, Martin Maiers, Mark Albrecht, Jason Dehn |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Time Factors Genotype Surrogate measure MEDLINE Human leukocyte antigen Prognostic score 03 medical and health sciences 0302 clinical medicine Unrelated Donor HLA Antigens Internal medicine Medicine Humans Registries Referral and Consultation Decision Making Computer-Assisted Transplantation business.industry Histocompatibility Testing Hematology Prognosis Histocompatibility Surgery 030220 oncology & carcinogenesis Ordered logit Supervised Machine Learning business Unrelated Donors Algorithms 030215 immunology |
| Zdroj: | Bone marrow transplantation. 51(11) |
| ISSN: | 1476-5365 |
| Popis: | A simple scoring system that can provide a quick search prognosis at the onset of an adult unrelated donor (URD) search could be a useful tool for transplant physicians. We aimed to determine whether patient human leukocyte Ag genotype frequency (GF) could be used as a surrogate measure of whether or not a potential 10/10 and/or 9/10 URD in the Be The Match Registry (BTMR) can be identified for the patient. GF was assigned on a training data set of 2410 patients that searched the BTMR using the reported ethnic group. A proportional odds model was used to correlate GF with defined search productivity categories as follows: 'Good' (2 10/10), 'Fair' (1-2 10/10 or No 10/10 and2 9/10) or 'Poor' (No 10/10 and3 9/10). A second cohort (n=2411) was used to calculate the concordance by the ethnic group in all three categories. In addition, we validated against an independent cohort (n=1344) resolved as having a 10/10 or 9/10 matched URD. Across the ethnic groups,90% of cases with 'Good' GF prognosis, 20-26% 'Fair' and10% 'Poor' had a 10/10 URD. Although not a replacement for an actual URD search, GF offers a quick way for transplant physicians to get an indication of the likely search outcome. |
| Databáze: | OpenAIRE |
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