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Published on: October 31, 2012
A nomogram model for predicting ocular GVHD following allo-HSCT based on risk factors
Wen-Hui Wang1, Li-Li You2, Ke-Zhi Huang3
1Department of Ophthalmology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, 107 West Yanjiang Road, Guangzhou, 510120, China.
Insights
A new nomogram model accurately predicts chronic ocular graft-versus-host disease (coGVHD) after allogeneic stem cell transplant. This tool aids in identifying high-risk patients to prevent vision loss.
Area of Science:
- Hematology
- Ophthalmology
- Transplantation Medicine
Background:
- Chronic ocular graft-versus-host disease (coGVHD) is a significant complication following allogeneic haematopoietic stem cell transplantation (allo-HSCT).
- Early identification and risk stratification of patients developing coGVHD are crucial for timely intervention and preventing irreversible vision impairment.
Purpose of the Study:
- To develop and validate a predictive nomogram model for chronic ocular graft-versus-host disease (coGVHD) in patients undergoing allo-HSCT.
- To identify key risk factors associated with coGVHD development post-transplantation.
Main Methods:
- A cohort of 61 patients surviving at least 100 days post-allo-HSCT was analyzed.
- LASSO regression identified risk factors, followed by logistic regression and nomogram construction.
- Model performance was assessed using Receiver Operating Characteristic (ROC) curves and the Hosmer-Lemeshow test.
Main Results:
- The nomogram incorporated lymphocytes, plasma thromboplastin antecedent, CD3+CD25+ cells, CD3+HLA-DR+ cells, and the Ocular Surface Disease Index (OSDI).
- The model demonstrated high predictive accuracy with Area Under the Curve (AUC) values of 0.979 for the training set and 0.969 for the test set.
- The Hosmer-Lemeshow test indicated good model fit for both training (p=0.9949) and test sets (p=0.9691).
Conclusions:
- A validated nomogram effectively predicts the risk of coGVHD in patients post-allo-HSCT.
- This predictive tool can assist clinicians in managing high-risk individuals and mitigating vision loss.
- Further research may refine this model for broader clinical application in transplantation centers.
Objective:
To develop and validate a nomogram model for predicting chronic ocular graft-versus-host disease (coGVHD) in patients after allogenic haematopoietic stem cell transplantation (allo-HSCT).
Methods:
This study included 61 patients who survived at least 100 days after allo-HSCT. Risk factors for coGVHD were screened using LASSO regression, then the variables selected were subjected to logistic regression. Nomogram was established to further confirm the risk factors for coGVHD. Receiver operating characteristic (ROC) curves were constructed to assess the performance of the predictive model with the training and test sets. Odds ratios and 95% confidence intervals (95% CIs) were calculated by using logistic regression analysis.
Results:
Among the 61 patients, 38 were diagnosed with coGVHD. We selected five texture features: lymphocytes (LYM) (OR = 2.26), plasma thromboplastin antecedent (PTA) (OR = 1.19), CD3 + CD25 + cells (OR = 1.38), CD3 + HLA-DR + cells (OR = 0.95), and the ocular surface disease index (OSDI) (OR = 1.44). The areas under the ROC curve (AUCs) of the nomogram with the training and test sets were 0.979 (95% CI, 0.895-1.000) and 0.969 (95% CI, 0.846-1.000), respectively.And the Hosmer-Lemeshow test was nonsignificant with the training (p = 0.9949) and test sets (p = 0.9691).
Conclusion:
We constructed a nomogram that can assess the risk of coGVHD in patients after allo-HSCT and help minimize the irreversible loss of vision caused by the disease in high-risk populations.
