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

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单位: [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
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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.

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出版当年[2020]版:
大类 | 2 区 医学
小类 | 2 区 血液学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 血液学
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出版当年[2019]版:
Q1 HEMATOLOGY
最新[2023]版:
Q1 HEMATOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者单位: [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
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通讯机构: [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 [*1]Peking Univ Peoples Hosp, 11 Xizhimen South St, Beijing, Peoples R China
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