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Hypoalbuminaemia segregates different prognostic subgroups within the refined standard risk acute graft‐versus‐host disease score
Author(s) -
KharfanDabaja Mohamed A.,
Sheets Kyle,
Kumar Ambuj,
Murthy Hemant S.,
Nishihori Taiga,
Tsalatsanis Athanasios,
Mina Alain,
Mathews John,
Ayala Ernesto,
Chavez Julio,
Perez Lia E.,
Betts Brian C.,
Anasetti Claudio,
Pidala Joseph
Publication year - 2018
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.15105
Subject(s) - medicine , disease , host (biology) , graft versus host disease , biology , genetics
Summary Hypoalbuminaemia has been previously described to predict worse non‐relapse mortality ( NRM ) and inferior overall survival ( OS ) in allogeneic haematopoietic cell transplant (allo‐ HCT ) recipients. Here, we evaluate the role of hypoalbuminaemia (<35 g/l) at time of onset of acute graft‐versus‐host disease ( aGVHD ) when incorporated into the refined aGVHD score. The study population consisted of 522 patients, median age 53 (18–75) years, who underwent an allo‐ HCT mostly for haematological malignancies. Standard risk ( SR ) aGVHD comprised 467 patients (89%) and the number of high risk ( HR ) cases was 55 (11%). Median follow‐up for all surviving patients was 26 (3–55) months. Two‐year OS was significantly better in patients with SR aGVHD with a serum albumin ≥35 g/l compared to SR with albumin <35 g/l [70% (95% CI = 64–76%) vs. 49% (95% CI = 42–56%), P < 0·0001]. Also, patients with SR aGVHD and a serum albumin level of ≥35 g/l had a significantly lower NRM at 1‐year post‐transplantation [6% (95% CI = 3–10%) vs. 25% (95% CI = 20–32%), P < 0·0001]. After our findings are validated in a large cohort of patients, we propose that hypoalbuminaemia should be incorporated into the refined aGVHD risk score to further its ability to predict outcomes within this group.