Reduced mortality after allogeneic hematopoietic-cell transplantation.
Ted Gooley,Jason W. Chien,Jason W. Chien,Steven A. Pergam,Steven A. Pergam,Sangeeta Hingorani,Sangeeta Hingorani,Mohamed L. Sorror,Mohamed L. Sorror,Michael Boeckh,Michael Boeckh,Paul J. Martin,Paul J. Martin,Brenda M. Sandmaier,Brenda M. Sandmaier,Kieren A. Marr,Kieren A. Marr,Frederick R. Appelbaum,Frederick R. Appelbaum,Rainer Storb,Rainer Storb,George B. McDonald,George B. McDonald +22 more
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TLDR
A substantial reduction in the hazard of death related to allogeneic hematopoietic-cell transplantation, as well as increased long-term survival, over the past decade is found.Abstract:
BACKGROUND Over the past decade, advances have been made in the care of patients undergoing transplantation. We conducted a study to determine whether these advances have improved the outcomes of transplantation. METHODS We analyzed overall mortality, mortality not preceded by relapse, recurrent malignant conditions, and the frequency and severity of major complications of transplantation, including graft-versus-host disease (GVHD) and hepatic, renal, pulmonary, and infectious complications, among 1418 patients who received their first allogeneic transplants at our center in Seattle in the period from 1993 through 1997 and among 1148 patients who received their first allogeneic transplants in the period from 2003 through 2007. Components of the Pretransplant Assessment of Mortality (PAM) score were used in regression models to adjust for the severity of illness at the time of transplantation. RESULTS In the 2003-2007 period, as compared with the 1993-1997 period, we observed significant decreases in mortality not preceded by relapse, both at day 200 (by 60%) and overall (by 52%), the rate of relapse or progression of a malignant condition (by 21%), and overall mortality (by 41%), after adjustment for components of the PAM score. The results were similar when the analyses were limited to patients who received myeloablative conditioning therapy. We also found significant decreases in the risk of severe GVHD; disease caused by viral, bacterial, and fungal infections; and damage to the liver, kidneys, and lungs. CONCLUSIONS We found a substantial reduction in the hazard of death related to allogeneic hematopoietic-cell transplantation, as well as increased long-term survival, over the past decade. Improved outcomes appear to be related to reductions in organ damage, infection, and severe acute GVHD. (Funded by the National Institutes of Health.).read more
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References
More filters
Journal ArticleDOI
Longitudinal data analysis using generalized linear models
Kung Yee Liang,Scott L. Zeger +1 more
TL;DR: In this article, an extension of generalized linear models to the analysis of longitudinal data is proposed, which gives consistent estimates of the regression parameters and of their variance under mild assumptions about the time dependence.
Journal Article
1994 Consensus Conference on Acute GVHD Grading.
Donna Przepiorka,Daniel J. Weisdorf,Paul J. Martin,Hans G. Klingemann,Beatty P,Hows J,Thomas Ed +6 more
TL;DR: Reports of GVHD prevention trials should include an accurate description of the grading system used and should report actuarial rates of grades II-IV and III-IV GV HD corrected for graft failure and potential interventions for early relapse.
Journal ArticleDOI
Estimation of failure probabilities in the presence of competing risks: new representations of old estimators
Ted Gooley,Ted Gooley,Wendy M. Leisenring,Wendy M. Leisenring,John Crowley,John Crowley,Barry E. Storer,Barry E. Storer +7 more
TL;DR: A representation of each estimate in a manner not ordinarily seen is presented, each representation utilizing the concept of censored observations being 'redistributed to the right' to allow a more intuitive understanding of each estimates.
Journal ArticleDOI
Defining Opportunistic Invasive Fungal Infections in Immunocompromised Patients with Cancer and Hematopoietic Stem Cell Transplants: An International Consensus
Sibel Ascioglu,John H. Rex,B.E. de Pauw,John E. Bennett,J. Bille,F. Crokaert,David W. Denning,J.P. Donnelly,J. E. Edwards,Z. Erjavec,D. Fiere,O. Lortholary,Johan Maertens,Jacques F. Meis,Thomas F. Patterson,J. Ritter,D. Selleslag,Palak Shah,David A. Stevens,Thomas J. Walsh +19 more
TL;DR: A set of research-oriented definitions for the IFIs most often seen and studied in immunocompromised patients with cancer is proposed and three levels of probability are proposed: "proven," "probable," and "possible."
Journal ArticleDOI
Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT.
Mohamed L. Sorror,Michael B. Maris,Michael B. Maris,Rainer Storb,Rainer Storb,Frédéric Baron,Brenda M. Sandmaier,Brenda M. Sandmaier,David G. Maloney,David G. Maloney,Barry E. Storer,Barry E. Storer +11 more
TL;DR: The new simple index provided valid and reliable scoring of pretransplant comorbidities that predicted nonrelapse mortality and survival and will be useful for clinical trials and patient counseling before HCT.
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