Mô hình dự đoán kết hợp các đặc điểm lâm sàng và yếu tố nguy cơ dinh dưỡng cho khả năng sống sót toàn diện sau ghép tế bào gốc máu cuống rốn

Stem Cell Research & Therapy - Tập 14 - Trang 1-13 - 2023
Meijuan Tu1, Aijie Huang1,2,3, Lijuan Ning4,5, Baolin Tang1,2,3, Chunli Zhang1, Guangyu Sun1, Xiang Wan1, Kaidi Song1, Wen Yao1, Ping Qiang1, Yue Wu1,2,3, Xiaoyu Zhu1,2,3
1Department of Hematology, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
2Anhui Provincial Key Laboratory of Blood Research and Applications, Hefei, China
3Blood and Cell Therapy Institute, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
4Department of Pharmacy, The First Affiliated Hospital of University of Science and Technology of China, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
5Anhui Provincial Key Laboratory of Precision Pharmaceutical Preparations and Clinical Pharmacy, Hefei, China

Tóm tắt

Ghép tế bào gốc máu cuống rốn (UCBT) là một liệu pháp có thể chữa khỏi cho các bệnh huyết học; tuy nhiên, tác động của tình trạng dinh dưỡng đến kết quả của UCBT vẫn còn gây tranh cãi. Để đánh giá tác động chung của các đặc điểm lâm sàng và tình trạng dinh dưỡng đối với tiên lượng của bệnh nhân đã trải qua UCBT, chúng tôi đã sàng lọc nhiều yếu tố để thiết lập một mô hình dự đoán khả năng sống sót toàn diện (OS) sau UCBT. Chúng tôi đã thực hiện một phân tích tích hợp các đặc điểm lâm sàng và yếu tố nguy cơ dinh dưỡng và建立了一个可用于识别OS较差的UCBT接受者的预测模型。我们通过使用500次重复的自助法进行了内部验证。四个因素,包括疾病状态、预处理方案、小腿皮肤折叠厚度和白蛋白水平,被确定并用于开发OS的风险评分,该评分显示出84.0%的正预测值。高风险评分(≥ 2.225)与UCBT后不良的三年OS相关[67.5%(95% CI 51.1–79.4%),P = 0.001]。随后,我们根据四个因素建立了一个名义图,显示了良好的区分能力,C-index值为0.833(95% CI 0.743–0.922)。自助法修正后的C-index值为0.804。多 biến phân tích cho thấy, một độ dày nếp gấp da bắp chân cao (≥ 20.5 mm) và mức albumin thấp (< 33.6 g/L) liên quan đến sự sống sót không bệnh (DFS) kém. Mô hình dự đoán kết hợp các yếu tố lâm sàng và dinh dưỡng có thể được sử dụng để dự đoán OS ở các bệnh nhân nhận UCBT, từ đó thúc đẩy điều trị dự phòng.

Từ khóa

#ghép tế bào gốc máu cuống rốn #bệnh huyết học #tình trạng dinh dưỡng #tiên lượng #mô hình dự đoán #sự sống sót toàn diện #yếu tố nguy cơ dinh dưỡng

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