Reevaluation of the Pretransplant Assessment of Mortality Score after Allogeneic Hematopoietic Transplantation Brandon K.C. Au, Ted A. Gooley, Philippe.

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Presentation transcript:

Reevaluation of the Pretransplant Assessment of Mortality Score after Allogeneic Hematopoietic Transplantation Brandon K.C. Au, Ted A. Gooley, Philippe Armand, Min Fang, David K. Madtes, Mohamed L. Sorror, Michael J. Boeckh, Christopher J. Gibson, Hans Joachim Deeg, Rainer Storb, Frederick R. Appelbaum, Jason W. Chien, Paul J. Martin Biology of Blood and Marrow Transplantation Volume 21, Issue 5, Pages 848-854 (May 2015) DOI: 10.1016/j.bbmt.2015.01.011 Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 1 Association of PAM score and the hazard of 2-year mortality when PAM is modeled as a cubic spline. Association is examined separately for patients in the previous validation cohort and for patients in the current cohort. HRs are indicated by thicker lines; pointwise 95% CIs are indicated by thinner lines. Biology of Blood and Marrow Transplantation 2015 21, 848-854DOI: (10.1016/j.bbmt.2015.01.011) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 2 Two-year survival for the current (A) and previous validation (B) cohorts, grouped into 4 separate PAM categorizations based on the original study, where scores were grouped as <17, 17-23, 24-30, and >30, with the upper interval of the first 3 windows chosen so the predicted probabilities of death by 2 years were 25%, 50%, and 75%, respectively, based on data from the original PAM development cohort. Category 1 (black): PAM < 17; category 2 (red): PAM 17-23; category 3 (blue): PAM 24-30; category 4 (green): PAM > 30. Absolute probabilities of survival are 79%, 63%, 47%, and 33% in the current cohort and 84%, 66%, 38%, and 17% in the previous validation cohort, respectively. Biology of Blood and Marrow Transplantation 2015 21, 848-854DOI: (10.1016/j.bbmt.2015.01.011) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 3 HRs for 2-year mortality with individual PAM variables modeled as cubic splines in the previous validation (black) and current (red) cohorts for patients who received myeloablative conditioning. (A) patient age; (B) ALT; (C) creatinine; (D) DLCO; (E) FEV1. HRs are indicated by thicker lines; pointwise 95% CIs are indicated by thinner lines. Biology of Blood and Marrow Transplantation 2015 21, 848-854DOI: (10.1016/j.bbmt.2015.01.011) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions

Figure 4 Two-year survival for the external validation cohort (n = 401) from the Dana Farber Cancer Institute, grouped into 5 separate PAM categorizations that were divided into intervals of similar length. The stratification of groupings by equal interval lengths is supported by Supplemental Figure 3, because the association appears relatively linear. Category 1 (black): PAM 0-9; category 2 (red): PAM 9-14; category 3 (blue): PAM 14-19; category 4 (green): PAM 19-24; category 5 (pink): PAM 24-41. Biology of Blood and Marrow Transplantation 2015 21, 848-854DOI: (10.1016/j.bbmt.2015.01.011) Copyright © 2015 American Society for Blood and Marrow Transplantation Terms and Conditions