A prognostic model (BATAP) with external validation for patients with transplant-associated thrombotic microangiopathy
| Autor: | Huan Chen, Wei Han, Shan Chong, Xiao Liu, Qiu-Sha Huang, Lan-Ping Xu, Jing-Zhi Wang, Xiao-Hui Zhang, Yun He, Qingyuan Qu, Xiang-Yu Zhao, Yu Wang, Ye-Jun Wu, Xiao-Lu Zhu, Xiao-Wan Sun, Xiao-Dong Mo, Xiao-Jun Huang, Rui-Xin Deng, Yuan-Yuan Zhang, Feng-Rong Wang, Yu-Hong Chen, Kai-Yan Liu, Ying-Jun Chang, Peng Zhao |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Thrombotic microangiopathy Bilirubin Anemia Clinical Trials and Observations medicine.medical_treatment Hematopoietic stem cell transplantation chemistry.chemical_compound immune system diseases Risk Factors Internal medicine hemic and lymphatic diseases Medicine Humans Retrospective Studies Proteinuria Framingham Risk Score business.industry Thrombotic Microangiopathies Hematopoietic Stem Cell Transplantation Hematology medicine.disease Prognosis Transplantation chemistry medicine.symptom business Complication |
| Zdroj: | Blood Advances |
| ISSN: | 2473-9537 2473-9529 |
| Popis: | Key Points A risk score model (BATAP) was established to facilitate the prognostic stratification of patients with TA-TMA following allo-HSCT.The BATAP prognostic model showed robust predictive capacity through internal and external temporal validation. Visual Abstract Transplant-associated thrombotic microangiopathy (TA-TMA) is a potentially life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Information on markers for early prognostication remains limited, and no predictive tools for TA-TMA are available. We attempted to develop and validate a prognostic model for TA-TMA. A total of 507 patients who developed TA-TMA following allo-HSCT were retrospectively identified and separated into a derivation cohort and a validation cohort, according to the time of transplantation, to perform external temporal validation. Patient age (odds ratio [OR], 2.371; 95% confidence interval [CI], 1.264-4.445), anemia (OR, 2.836; 95% CI, 1.566-5.138), severe thrombocytopenia (OR, 3.871; 95% CI, 2.156-6.950), elevated total bilirubin (OR, 2.716; 95% CI, 1.489-4.955), and proteinuria (OR, 2.289; 95% CI, 1.257-4.168) were identified as independent prognostic factors for the 6-month outcome of TA-TMA. A risk score model termed BATAP (Bilirubin, Age, Thrombocytopenia, Anemia, Proteinuria) was constructed according to the regression coefficients. The validated c-statistic was 0.816 (95%, CI, 0.766-0.867) and 0.756 (95% CI, 0.696-0.817) for the internal and external validation, respectively. Calibration plots indicated that the model-predicted probabilities correlated well with the actual observed frequencies. This predictive model may facilitate the prognostication of TA-TMA and contribute to the early identification of high-risk patients. |
| Databáze: | OpenAIRE |
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