title: Validation and refinement of the Disease Risk Index for allogeneic stem cell transplantation.
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.
authors.affiliation: Department of Medical Oncology and.
authors.forename: Philippe
authors.initials: P
authors.lastname: Armand
authors.affiliation: Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston MA;
authors.forename: Haesook T
authors.initials: HT
authors.lastname: Kim
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine and Division of Biostatistics, Institute for Health and Society, Medical College of Wisconsin, Milwaukee, WI;
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine and.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Medical Oncology and.
authors.forename: Edwin P
authors.initials: EP
authors.lastname: Alyea
authors.affiliation: Department of Hematologic Oncology and Blood Disorders, Cleveland Clinic, Cleveland, OH;
authors.forename: Matt E
authors.initials: ME
authors.lastname: Kalaycio
authors.affiliation: Center for Hematologic Malignancies, Knight Cancer Institute, Oregon Health & Science University, Portland, OR; and.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.affiliation: Department of Medical Oncology and.
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Antin
authors.affiliation: Department of Medical Oncology and.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Soiffer
authors.affiliation: Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Weisdorf
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine and.
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine and.
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.affiliation: Center for International Blood and Marrow Transplant Research, Department of Medicine and.
authors.forename: Wael
authors.initials: W
authors.lastname: Saber
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006305:Health Status Indicators; D019337:Hematologic Neoplasms / Q000401:mortality* / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D019172:Transplantation Conditioning / Q000401:mortality; D014184:Transplantation, Homologous / Q000009:adverse effects; D055815:Young Adult
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