Quality-adjusted time without symptoms or toxicity analysis of haploidentical-related donor vs. identical sibling donor hematopoietic stem cell transplantation in acute myeloid leukemia

作者：Yuewen Wang, Xianli Gao, Ting Wang, Xiaohui Zhang, Lan-Ping Xu, Yu Wang, Chen-Hua Yan, Huan Chen, Yuhong Chen, Wei Han, Feng‐Rong Wang, Jingzhi Wang, Xia Yan, Xiao‐Dong Mo · 发表于：Chinese Journal of Cancer Research · 年份：2024 · DOI：10.21147/j.issn.1000-9604.2024.05.06 · 被引用次数：16 · 研究领域：Hematopoietic Stem Cell Transplantation、Acute Myeloid Leukemia Research、Neutropenia and Cancer Infections

ObjectiveWe aimed to compare the quality-adjusted time without symptoms or toxicity (Q-TWiST) in acute myeloid leukemia (AML) patients who received haploidentical-related donor (HID) and identical sibling donor (ISD) hematopoietic stem cell transplantation (HSCT). MethodsFive clinical health states were defined: toxicity (TOX), acute graft-versus-host disease (GVHD), chronic GVHD (cGVHD), time without symptoms and toxicity (TWiST) and relapse (REL). The equation used in this study was as follows: Q-TWiST=UTOX × TOX + UTWiST × TWiST + UREL × REL + UaGVHD × aGVHD + UcGVHD × cGVHD. ResultsA total of 239 AML patients were enrolled. We established a mathematical model, i.e., Q-TWiST HID HSCT > Q-TWiST ISD HSCT, to explore the range of utility coefficients satisfying the inequality. Based on the raw data, the utility coefficient is equivalent to the following inequality: \begin{document}$ 10.57067{U}_{TOX}-46.27733{U}_{REL}+ $\end{document} \begin{document}$ 105.9374+3.388078{U}_{aGVHD}-210.8198{U}_{cGVHD} > 0 $\end{document} . The model showed that when \begin{document}$ {U}_{TOX} $\end{document} , \begin{document}$ {U}_{REL} $\end{document} , and \begin{document}$ {U}_{aGVHD} $\end{document} were within the range of 0−1, as well as when \begin{document}$ {U}_{cGVHD} $\end{document} was within the range of 0−0.569, the inequality Q-TWiST HID HSCT > Q-TWiST ISD HSCT was valid. According to the results of the ChiCTR1800016972 study, the median coefficients of TOX, acute GVHD (aGVHD)...