Risk Factors and Predictive Model of Poor Graft Function After Allogeneic Hematopoietic Stem Cell Transplantation

Area of Science:

• Hematology
• Immunology
• Transplantation Science

Background:

• Poor graft function (PGF) is a critical complication of allogeneic hematopoietic stem cell transplantation (allo-HSCT).
• Current treatments for PGF have limited efficacy, necessitating improved methods for early identification and prevention.
• Prognosis for allo-HSCT recipients is significantly impacted by graft function.

Purpose of the Study:

• To identify independent risk factors for PGF following allo-HSCT.
• To develop and validate a nomogram-based predictive model for PGF.
• To assess the clinical utility of the predictive model in stratifying patient risk.

Main Methods:

• A real-world study analyzing data from 795 patients undergoing allo-HSCT for hematological malignancies.
• Identification of independent risk factors using statistical analysis.
• Construction and validation of a nomogram predictive model incorporating ten clinical predictors.

Main Results:

• Key risk factors for PGF include lower CD34+ cell dose, infection, cytomegalovirus activation, splenomegaly, and anti-HLA antibodies.
• The predictive model demonstrated strong performance (C-statistic = 0.782) and excellent calibration.
• Patients with good graft function had significantly higher 3-year overall survival (OS) compared to PGF cohorts (78.1% vs. 50.6%).

Conclusions:

• The developed nomogram is a valuable tool for identifying patients at high risk of PGF post-allo-HSCT.
• Early identification enables targeted preventive strategies, potentially improving patient outcomes and survival.
• The model aids in risk stratification, facilitating personalized treatment approaches for allo-HSCT recipients.