Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation.

Philippe Armand, Haesook T. Kim, Brent R. Logan, Zhiwei Wang, Edwin P. Alyea, Matt E. Kalaycio, Richard Maziarz, Joseph H. Antin, Robert J. Soiffer, Daniel J. Weisdorf, J. Douglas Rizzo, Mary M. Horowitz, Wael Saber

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288 Scopus citations

Abstract

Because the outcome of allogeneic hematopoietic cell transplantation (HCT) is predominantly influenced by disease type and status, it is essential to be able to stratify patients undergoing HCT by disease risk. The Disease Risk Index (DRI) was developed for this purpose. In this study, we analyzed 13,131 patients reported to the Center for International Blood and Marrow Transplant Research who underwent HCT between 2008 and 2010. The DRI stratified patients into 4 groups with 2-year overall survival (OS) ranging from 64% to 24% and was the strongest prognostic factor, regardless of age, conditioning intensity, graft source, or donor type. A randomly selected training subgroup of 9849 patients was used to refine the DRI, using a multivariable regression model for OS. This refined DRI had improved prediction ability for the remaining 3282 patients compared with the original DRI or other existing schemes. This validated and refined DRI can be used as a 4- or 3-group index, depending on the size of the cohort under study, for prognostication; to facilitate the interpretation of single-center, multicenter, or registry studies; to adjust center outcome data; and to stratify patients entering clinical trials that enroll patients across disease categories.

Original languageEnglish (US)
Pages (from-to)3664-3671
Number of pages8
JournalBlood
Volume123
Issue number23
DOIs
Publication statusPublished - 2014

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ASJC Scopus subject areas

  • Hematology
  • Biochemistry
  • Cell Biology
  • Immunology

Cite this

Armand, P., Kim, H. T., Logan, B. R., Wang, Z., Alyea, E. P., Kalaycio, M. E., ... Saber, W. (2014). Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation. Blood, 123(23), 3664-3671. https://doi.org/10.1182/blood-2014-01-552984