A Validated Risk Stratification That Incorporates MAGIC Biomarkers Predicts Long-Term Outcomes in Pediatric Patients with Acute GVHD
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Le résumé fourni par la source
Acute graft versus host disease (GVHD) is a common and serious complication of allogeneic hematopoietic cell transplantation (HCT) in children but overall clinical grade at onset only modestly predicts response to treatment and survival outcomes. Two tools to assess risk at initiation of treatment were recently developed. The Minnesota risk system stratifies children for risk of nonrelapse mortality (NRM) according to the pattern of GVHD target organ severity. The Mount Sinai Acute GVHD International Consortium (MAGIC) algorithm of 2 serum biomarkers (ST2 and REG3α) predicts NRM in adult patients but has not been validated in a pediatric population. We aimed to develop and validate a system that stratifies children at the onset of GVHD for risk of 6-month NRM. We determined the MAGIC algorithm probabilities (MAPs) and Minnesota risk for a multicenter cohort of 315 pediatric patients who developed GVHD requiring treatment with systemic corticosteroids. MAPs created 3 risk groups with distinct outcomes at the start of treatment and were more accurate than Minnesota risk stratification for prediction of NRM (area under the receiver operating curve (AUC), .79 versus .62, P = .001). A novel model that combined Minnesota risk and biomarker scores created from a training cohort was more accurate than either biomarkers or clinical systems in a validation cohort (AUC .87) and stratified patients into 2 groups with highly different 6-month NRM (5% versus 38%, P < .001). In summary, we validated the MAP as a prognostic biomarker in pediatric patients with GVHD, and a novel risk stratification that combines Minnesota risk and biomarker risk performed best. Biomarker-based risk stratification can be used in clinical trials to develop more tailored approaches for children who require treatment for GVHD.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A Validated Risk Stratification That Incorporates MAGIC Biomarkers Predicts Long-Term Outcomes in Pediatric Patients with Acute GVHD
- Date Crossref
- 01/06/2024
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Emory University Department of Pediatrics pays non établi dans la noticeUniversité ou école supérieure
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Aflac (United States) pays non établi dans la noticeEntreprise
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Children's Healthcare of Atlanta pays non établi dans la noticeÉtablissement de santé
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Tisch Hospital pays non établi dans la noticeÉtablissement de santé
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Icahn School of Medicine at Mount Sinai The Tisch Cancer Institute and Division of Hematology/Medical Oncology pays non établi dans la noticeUniversité ou école supérieure
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Children's Hospital of Los Angeles pays non établi dans la noticeOrganisme public
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Universität Hamburg pays non établi dans la noticeUniversité ou école supérieure
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University Medical Center Hamburg-Eppendorf Department of Stem Cell Transplantation pays non établi dans la noticeÉtablissement de santé
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The Ohio State University Wexner Medical Center pays non établi dans la noticeÉtablissement de santé
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Massachusetts General Hospital Hematopoietic Cell Transplant and Cellular Therapy Program pays non établi dans la noticeÉtablissement de santé
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Children's Hospital of Philadelphia Division of Oncology pays non établi dans la noticeOrganisme public
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Hospital of the University of Pennsylvania Abramson Cancer Center and the Division of Hematology and Oncology pays non établi dans la noticeÉtablissement de santé
Department of Pediatrics — Emory University, Aflac (United States) et Children's Healthcare of Atlanta, avec 9 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.