The Effect of GVHD on Long-term Outcomes after Peripheral Blood Allogeneic Stem Cell Transplantation from an HLA-identical Sibling in Adult Acute Lymphocytic Leukemia: A Landmark Analysis Approach in Competing Risks.

摘要: Allogeneic Hematopoietic stem cell transplantation (HSCT) is the most effective therapy to prevent relapse in acute lymphocytic leukemia (ALL). This benefit affected by non-relapse mortality (NRM) due complications such as graft versus host disease (GVHD). A new approach analyzing time-dependent covariates competing risks landmark analysis. So, aim of this study evaluate effect and chronic GVHD on long-term outcomes, NRM, after allogeneic HSCT adult ALL using analysis. This was conducted 252 patients who were transplanted from an HLA-identical sibling with peripheral blood (PB) source 2004 2012 followed-up until 2013. In first 100 days transplant, a analysis +10, +11, +12, +17, +24, +31 applied assess early NRM. Similarly, for alive event-free at day +100 time points +101, months +4, +5, +6, +9, +12 late NRM. Five-year LFS OS 35.0% (95% CI: 29.1, 42.2%) 37.5% 31.3, 45.0%), respectively. Five-year cumulative incidence 44.5% 37.9, 51.0%) while 20.4% 15.4, 26.0%) The transplant showed that grade III/IV aGVHD has lower risk but higher NRM adjustment EBMT score. For +100, cGVHD had no significant relapse. Limited 6 month post-transplant decreased there not important difference between groups cGVHD. Using advanced models enables us estimate effects more precisely ultimately make inference accurately.