PMID- 35081688
OWN - NLM
STAT- MEDLINE
DCOM- 20220704
LR  - 20220924
IS  - 1592-8721 (Electronic)
IS  - 0390-6078 (Print)
IS  - 0390-6078 (Linking)
VI  - 107
IP  - 7
DP  - 2022 Jul 1
TI  - A risk score based on real-world data to predict early death in acute 
      promyelocytic leukemia.
PG  - 1528-1537
LID - 10.3324/haematol.2021.280093 [doi]
AB  - With increasingly effective treatments, early death (ED) has become the 
      predominant reason for therapeutic failure in patients with acute promyelocytic 
      leukemia (APL). To better prevent ED, patients with high-risk of ED must be 
      identified. Our aim was to develop a score that predicts the risk of ED in a 
      real-life setting. We used APL patients in the populationbased Swedish AML 
      Registry (n=301) and a Portuguese hospital-based registry (n=129) as training and 
      validation cohorts, respectively. The cohorts were comparable with respect to age 
      (median, 54 and 53 years) and ED rate (19.6% and 18.6%). The score was developed 
      by logistic regression analyses, risk-per-quantile assessment and scoring based 
      on ridge regression coefficients from multivariable penalized logistic regression 
      analysis. White blood cell count, platelet count and age were selected by this 
      approach as the most significant variables for predicting ED. The score 
      identified low-, high- and very high-risk patients with ED risks of 4.8%, 20.2% 
      and 50.9% respectively in the training cohort and with 6.7%, 25.0% and 36.0% as 
      corresponding values for the validation cohort. The score identified an increased 
      risk of ED already at sub-normal and normal white blood cell counts and, 
      consequently, it was better at predicting ED risk than the Sanz score (AUROC 0.77 
      vs. 0.64). In summary, we here present an externally validated and 
      population-based risk score to predict ED risk in a real-world setting, 
      identifying patients with the most urgent need of aggressive ED prevention. The 
      results also suggest that increased vigilance for ED is already necessary at 
      sub-normal/normal white blood cell counts.
FAU - Osterroos, Albin
AU  - Osterroos A
AD  - Department of Medical Sciences, Uppsala University, Uppsala.
FAU - Maia, Tania
AU  - Maia T
AD  - Department of Clinical Hematology, University Hospital Center of Sao Joao, Porto.
FAU - Eriksson, Anna
AU  - Eriksson A
AD  - Department of Medical Sciences, Uppsala University, Uppsala.
FAU - Jadersten, Martin
AU  - Jadersten M
AD  - Department of Hematology, Karolinska University Hospital, Stockholm.
FAU - Lazarevic, Vladimir
AU  - Lazarevic V
AD  - Department of Hematology, Skane University Hospital, Lund, Sweden; Stem Cell 
      Center, Department of Hematology, Department of Laboratory Medicine, Lund 
      University, Lund.
FAU - Wennstrom, Lovisa
AU  - Wennstrom L
AD  - Department of Hematology, Sahlgrenska University Hospital, Gothenburg.
FAU - Antunovic, Petar
AU  - Antunovic P
AD  - Department of Hematology, Linkoping University Hospital, Linkoping.
FAU - Cammenga, Jorg
AU  - Cammenga J
AD  - Department of Hematology, Linkoping University Hospital, Linkoping.
FAU - Deneberg, Stefan
AU  - Deneberg S
AD  - Department of Hematology, Karolinska University Hospital, Stockholm.
FAU - Lorenz, Fryderyk
AU  - Lorenz F
AD  - Department of Hematology, Norrland University Hospital, Umea.
FAU - Mollgard, Lars
AU  - Mollgard L
AD  - Department of Hematology, Sahlgrenska University Hospital, Gothenburg.
FAU - Uggla, Bertil
AU  - Uggla B
AD  - Department of Medicine, Division of Hematology, Orebro University Hospital, 
      Orebro.
FAU - Olander, Emma
AU  - Olander E
AD  - Department of Hematology, Sundsvall Hospital, Sundsvall.
FAU - Aguiar, Eliana
AU  - Aguiar E
AD  - Department of Clinical Hematology, University Hospital Center of Sao Joao, Porto.
FAU - Trigo, Fernanda
AU  - Trigo F
AD  - Department of Clinical Hematology, University Hospital Center of Sao Joao, Porto.
FAU - Hoglund, Martin
AU  - Hoglund M
AD  - Department of Medical Sciences, Uppsala University, Uppsala.
FAU - Juliusson, Gunnar
AU  - Juliusson G
AD  - Department of Hematology, Skane University Hospital, Lund, Sweden; Stem Cell 
      Center, Department of Hematology, Department of Laboratory Medicine, Lund 
      University, Lund.
FAU - Lehmann, Soren
AU  - Lehmann S
AD  - Department of Medical Sciences, Uppsala University, Uppsala, Sweden; Department 
      of Hematology, Karolinska University Hospital, Stockholm. 
      soren.lehmann@medsci.uu.se.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220701
PL  - Italy
TA  - Haematologica
JT  - Haematologica
JID - 0417435
SB  - IM
CIN - Haematologica. 2022 Jul 01;107(7):1498-1499. PMID: 35081691
MH  - Cohort Studies
MH  - Humans
MH  - *Leukemia, Promyelocytic, Acute/diagnosis/epidemiology/therapy
MH  - Leukocyte Count
MH  - Risk Factors
MH  - Treatment Outcome
PMC - PMC9244824
EDAT- 2022/01/28 06:00
MHDA- 2022/07/06 06:00
PMCR- 2022/01/27
CRDT- 2022/01/27 02:31
PHST- 2021/09/29 00:00 [received]
PHST- 2022/01/28 06:00 [pubmed]
PHST- 2022/07/06 06:00 [medline]
PHST- 2022/01/27 02:31 [entrez]
PHST- 2022/01/27 00:00 [pmc-release]
AID - 10.3324/haematol.2021.280093 [doi]
PST - epublish
SO  - Haematologica. 2022 Jul 1;107(7):1528-1537. doi: 10.3324/haematol.2021.280093.