Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Zach, V.
Retrospective evaluation of pretreatment prognostic indicators in patients with lymphoma after autologous or allogeneic stem cell transplantation
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2017. pp. 76
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Neumeister Peter
- Prochazka Katharina
- Altmetrics:
- Abstract:
- Background: With more than 100,000 newly diagnosed cases each year, Multiple Myeloma (MM) ranks among the most common types of blood cancers. In the last decade, increased research led to the development of a multitude of new treatment strategies. All these new and promising therapeutic approaches resulted in the need of a reevaluation of the role of stem cell transplantation in myeloma patients. Autologous and allogeneic stem cell transplantation are still considered high-risk procedures and reliable prognostic indicators for inferior/ superior outcome after the transplantation have not been detected and analysed sufficiently. The ideal prognostic parameter should be easy, fast and cheap to measure and monitor before the transplantation. The aim of this retrospective study was to identify patient characteristics and laboratory parameters that influence Progression Free Survival (PFS) and Overall Survival (OS). Material and Methods: This retrospective study is based on a population of 232 patients diagnosed with MM and treated with stem cell transplantation at the Landeskrankenhaus Graz und Landeskrankenhaus Hochsteiermark between 2004 and 2015. Over 30 different patient characteristics and laboratory parameters at the date of admission for stem cell transplantation documented in the MEDOC System were collected and analysed with regard to their influence on PFS and OS. The statistical evaluation, including descriptive data analysis, univariate Cox Hazards Models and Kaplan-Meier estimators, was performed using EXCEL 2010 and SPSS 23. Results: The statistical evaluation revealed decreased haemoglobin levels (<12 g/dl vs =12 g/dl, p=0.0238), reduced thrombocyte levels (<100 G/l vs =100 G/l, p<0.0001) and a low lymphocyte/monocyte ratio (<1.2 vs =1.2, p=0.0452) as factors associated with inferior OS. Furthermore, univariate Cox Hazard Models and Kaplan-Meier estimators identified elevated CRP as an independent prognostic indicator for superior PFS (=5mg/l vs >5mg/l, p=0.0262). Conclusion: In this study we demonstrated that pre-transplantation haemoglobin, thrombocyte count, lymphocyte/monocyte ratio and CRP influence the further course of patients after stem cell transplantation in MM. After the confirmation of these results in a larger, prospective study the next step could include improving the outcome of many MM patients after stem cell transplantation by – as far as possible in an acute, clinical setting – adjusting these parameters before the patient undergoes transplantation.