Kaplan–Meier method is inappropriate for estimating cumulative incidence of graft‐versus‐host disease in the presence of competing events

Viana, Marcos Borato; Oliveira, Benigna Maria de; Cancela, Camila Silva Peres

doi:10.1002/ajh.21681

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…We used the ‘stcrreg’ command in STATA statistical software for the semi-parametric competing risk regression analysis of Fine and Gray [15] to investigate the relationship between the polymorphisms and the cumulative risk of GVHD, because this statistical tool has been considered to be the most appropriate approach for the analysis of cumulative incidence of GVHD which is significantly influenced by competing events [16]. …”

Section: Methodsmentioning

confidence: 99%

RANTES Polymorphisms and the Risk of Graft-versus-Host Disease in Human Leukocyte Antigen-Matched Sibling Allogeneic Hematopoietic Stem Cell Transplantation

Shin

Kim²,

Kim

et al. 2012

Acta Haematol

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We investigated the association between RANTES (regulated upon activation, normal T cell expressed and secreted) polymorphisms and clinical outcomes in patients treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Three RANTES gene polymorphisms, i.e. –403G/A (rs2107538), –28C/G (rs2280788) and In1.1T/C (rs2280789), were genotyped, and the effects of the genotypes and haplotypes of RANTES on clinical outcomes were analyzed. The competing risk regression analysis was used to investigate the relationship between the polymorphisms and the cumulative risk of graft-versus-host disease (GVHD). An AGC haplotype in a recessive model showed significant harmful effects on the cumulative risk of acute GVHD and relapse-free survival (adjusted hazard ratios 2.42 and 2.71, 95% confidence intervals 1.29–4.55 and 1.30–5.64; p = 0.018 and 0.024, respectively), whereas a GCT haplotype did not. RANTES polymorphisms were not significantly associated with overall survival and the risk of chronic GVHD. This study suggests that RANTES polymorphisms might be associated with the occurrence of acute GVHD rather than of chronic GVHD and also of relapse-free survival in the patients treated with allo-HSCT. Further larger prospective investigations are needed to establish the role of RANTES polymorphisms in patients treated with allo-HSCT.

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Section: Methodsmentioning

confidence: 99%

RANTES Polymorphisms and the Risk of Graft-versus-Host Disease in Human Leukocyte Antigen-Matched Sibling Allogeneic Hematopoietic Stem Cell Transplantation

Shin

Kim²,

Kim

et al. 2012

Acta Haematol

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“…The cumulative incidence of CNS relapse was estimated according to the method reported by Gray (15) considering the presence of competing events at the time of CNS relapse (16) . For this analysis, treatment failure was classified as: a) isolated CNS relapse; b) combined CNS and bone marrow relapse; c) other isolated or combined relapses; d) death while in remission.…”

Section: Methodsmentioning

confidence: 99%

Incidence and risk factors for central nervous system relapse in children and adolescents with acute lymphoblastic leukemia

Cancela¹,

Murao²,

Viana³

et al. 2012

Revista Brasileira De Hematologia E Hemoterapia

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Background: Despite all the advances in the treatment of childhood acute lymphoblastic leukemia, central nervous system relapse remains an important obstacle to curing these patients. This study analyzed the incidence of central nervous system relapse and the risk factors for its occurrence in children and adolescents with acute lymphoblastic leukemia. Methods: This study has a retrospective cohort design. The studied population comprised 199 children and adolescents with a diagnosis of acute lymphoblastic leukemia followed up at Hospital das Clinicas, Universidade Federal de Minas Gerais (HC-UFMG) between March 2001 and August 2009 and submitted to the Grupo Brasileiro de Tratamento de Leucemia da Infância-acute lymphoblastic leukemia (GBTLI-LLA-99) treatment protocol. Results: The estimated probabilities of overall survival and event free survival at 5 years were 69.5% (± 3.6%) and 58.8% (± 4.0%), respectively. The cumulative incidence of central nervous system (isolated or combined) relapse was 11.0% at 8 years. The estimated rate of isolated central nervous system relapse at 8 years was 6.8%. In patients with a blood leukocyte count at diagnosis ≥ 50 x 10 9 /L, the estimated rate of isolated or combined central nervous system relapse was higher than in the group with a count < 50 x 10 9 /L (p-value = 0.0008). There was no difference in cumulative central nervous system relapse (isolated or combined) for the other analyzed variables: immunophenotype, traumatic lumbar puncture, interval between diagnosis and first lumbar puncture and place where the procedure was performed. Conclusions: These results suggest that a leukocyte count > 50 x 10 9 /L at diagnosis seems to be a significant prognostic factor for a higher incidence of central nervous system relapse in childhood acute lymphoblastic leukemia.

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Incidence and risk factors for central nervous system relapse in children and adolescents with acute lymphoblastic leukemia

Cancela¹,

Murao²,

Viana³

et al. 2012

Revista Brasileira De Hematologia E Hemoterapia

View full text Add to dashboard Cite

BackgroundDespite all the advances in the treatment of childhood acute lymphoblastic leukemia, central nervous system relapse remains an important obstacle to curing these patients. This study analyzed the incidence of central nervous system relapse and the risk factors for its occurrence in children and adolescents with acute lymphoblastic leukemia. Methods This study has a retrospective cohort design. The studied population comprised 199 children and adolescents with a diagnosis of acute lymphoblastic leukemia followed up at Hospital das Clinicas, Universidade Federal de Minas Gerais (HC-UFMG) between March 2001 and August 2009 and submitted to the Grupo Brasileiro de Tratamento de Leucemia da Infância - acute lymphoblastic leukemia (GBTLI-LLA-99) treatment protocol. Results The estimated probabilities of overall survival and event free survival at 5 years were 69.5% (± 3.6%) and 58.8% (± 4.0%), respectively. The cumulative incidence of central nervous system (isolated or combined) relapse was 11.0% at 8 years. The estimated rate of isolated central nervous system relapse at 8 years was 6.8%. In patients with a blood leukocyte count at diagnosis ≥ 50 x 109/L, the estimated rate of isolated or combined central nervous system relapse was higher than in the group with a count < 50 x 109/L (p-value = 0.0008). There was no difference in cumulative central nervous system relapse (isolated or combined) for the other analyzed variables: immunophenotype, traumatic lumbar puncture, interval between diagnosis and first lumbar puncture and place where the procedure was performed. Conclusions These results suggest that a leukocyte count > 50 x 109/L at diagnosis seems to be a significant prognostic factor for a higher incidence of central nervous system relapse in childhood acute lymphoblastic leukemia.

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Kaplan–Meier method is inappropriate for estimating cumulative incidence of graft‐versus‐host disease in the presence of competing events

Cited by 3 publications

References 6 publications

RANTES Polymorphisms and the Risk of Graft-versus-Host Disease in Human Leukocyte Antigen-Matched Sibling Allogeneic Hematopoietic Stem Cell Transplantation

RANTES Polymorphisms and the Risk of Graft-versus-Host Disease in Human Leukocyte Antigen-Matched Sibling Allogeneic Hematopoietic Stem Cell Transplantation

Incidence and risk factors for central nervous system relapse in children and adolescents with acute lymphoblastic leukemia

Incidence and risk factors for central nervous system relapse in children and adolescents with acute lymphoblastic leukemia

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