Effectivity of a modified Sanz risk model for early death prediction in patients with newly diagnosed acute promyelocytic leukemia
Early death is the main obstacle for the cure of patients with acute promyelocytic leukemia (APL). We have analyzed risk factors of early death from 526 consecutive newly diagnosed APL patients between 2004 and 2016. The overall incidence of early death was 7.2% (38/526). The peak hazard of early de...
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| Veröffentlicht in: | Annals of hematology 2017-11, Vol.96 (11), p.1793-1800 |
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| container_title | Annals of hematology |
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| creator | Lou, Yinjun Ma, Yafang Sun, Jianai Suo, Sansan Tong, Hongyan Qian, Wenbin Mai, Wenyuan Meng, Haitao Jin, Jie |
| description | Early death is the main obstacle for the cure of patients with acute promyelocytic leukemia (APL). We have analyzed risk factors of early death from 526 consecutive newly diagnosed APL patients between 2004 and 2016. The overall incidence of early death was 7.2% (38/526). The peak hazard of early death occurred in the first 0–3 days. Multivariate logistic analysis demonstrated white blood cell (WBC) counts [odds ratio (OR) = 1.039; 95% confidence interval (CI): 1.024–1.055;
P
40 × 10
9
/L), intermediate risk (WBC/platelet 60, not in low and ultra-high risk) and ultra-high risk (WBC > 50 × 10
9
/L), the early death rates were 0, 0.6, 12.8, and 41.2%, respectively. In conclusion, we proposed a modified Sanz risk model as a useful predictor of early death risk in patients with APL. |
| doi_str_mv | 10.1007/s00277-017-3096-5 |
| format | Article |
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P
< 0.001], age (OR = 1.061; 95% CI: 1.025–1.099;
P
= 0.001) and platelet counts (OR = 0.971; 95% CI: 0.944–0.999;
P
= 0.038) were independent risk factors for early death. Furthermore, receiver-operator characteristic (ROC) curve analyses revealed a simple WBC/platelet ratio was significantly more accurate in predicting early death [areas under the ROC curve (AUC) = 0.842, 95% CI: 0.807–0.872) than WBC counts (AUC = 0.793; 95% CI: 0.756–0.827) or Sanz score (AUC = 0.746; 95% CI: 0.706–0.783). We stratified APL patients into four risk subgroups: low risk (WBC ≤ 10 × 10
9
/L, platelet >40 × 10
9
/L), intermediate risk (WBC/platelet <0.2 and age ≤ 60, not in low risk), high risk (WBC/platelet ≥0.2 or age > 60, not in low and ultra-high risk) and ultra-high risk (WBC > 50 × 10
9
/L), the early death rates were 0, 0.6, 12.8, and 41.2%, respectively. In conclusion, we proposed a modified Sanz risk model as a useful predictor of early death risk in patients with APL.</description><identifier>ISSN: 0939-5555</identifier><identifier>EISSN: 1432-0584</identifier><identifier>DOI: 10.1007/s00277-017-3096-5</identifier><identifier>PMID: 28823055</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Female ; Hematology ; Humans ; Leukemia ; Leukemia, Promyelocytic, Acute - diagnosis ; Leukemia, Promyelocytic, Acute - mortality ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Models, Theoretical ; Mortality - trends ; Oncology ; Original Article ; Predictive Value of Tests ; Prospective Studies ; Retrospective Studies ; Risk Factors</subject><ispartof>Annals of hematology, 2017-11, Vol.96 (11), p.1793-1800</ispartof><rights>Springer-Verlag GmbH Germany 2017</rights><rights>Annals of Hematology is a copyright of Springer, 2017.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-51a0b9fc7736821fe6939a96b834dda891ae74992527d3cf617043a6e7030de93</citedby><cites>FETCH-LOGICAL-c372t-51a0b9fc7736821fe6939a96b834dda891ae74992527d3cf617043a6e7030de93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00277-017-3096-5$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00277-017-3096-5$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28823055$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lou, Yinjun</creatorcontrib><creatorcontrib>Ma, Yafang</creatorcontrib><creatorcontrib>Sun, Jianai</creatorcontrib><creatorcontrib>Suo, Sansan</creatorcontrib><creatorcontrib>Tong, Hongyan</creatorcontrib><creatorcontrib>Qian, Wenbin</creatorcontrib><creatorcontrib>Mai, Wenyuan</creatorcontrib><creatorcontrib>Meng, Haitao</creatorcontrib><creatorcontrib>Jin, Jie</creatorcontrib><title>Effectivity of a modified Sanz risk model for early death prediction in patients with newly diagnosed acute promyelocytic leukemia</title><title>Annals of hematology</title><addtitle>Ann Hematol</addtitle><addtitle>Ann Hematol</addtitle><description>Early death is the main obstacle for the cure of patients with acute promyelocytic leukemia (APL). We have analyzed risk factors of early death from 526 consecutive newly diagnosed APL patients between 2004 and 2016. The overall incidence of early death was 7.2% (38/526). The peak hazard of early death occurred in the first 0–3 days. Multivariate logistic analysis demonstrated white blood cell (WBC) counts [odds ratio (OR) = 1.039; 95% confidence interval (CI): 1.024–1.055;
P
< 0.001], age (OR = 1.061; 95% CI: 1.025–1.099;
P
= 0.001) and platelet counts (OR = 0.971; 95% CI: 0.944–0.999;
P
= 0.038) were independent risk factors for early death. Furthermore, receiver-operator characteristic (ROC) curve analyses revealed a simple WBC/platelet ratio was significantly more accurate in predicting early death [areas under the ROC curve (AUC) = 0.842, 95% CI: 0.807–0.872) than WBC counts (AUC = 0.793; 95% CI: 0.756–0.827) or Sanz score (AUC = 0.746; 95% CI: 0.706–0.783). We stratified APL patients into four risk subgroups: low risk (WBC ≤ 10 × 10
9
/L, platelet >40 × 10
9
/L), intermediate risk (WBC/platelet <0.2 and age ≤ 60, not in low risk), high risk (WBC/platelet ≥0.2 or age > 60, not in low and ultra-high risk) and ultra-high risk (WBC > 50 × 10
9
/L), the early death rates were 0, 0.6, 12.8, and 41.2%, respectively. In conclusion, we proposed a modified Sanz risk model as a useful predictor of early death risk in patients with APL.</description><subject>Aged</subject><subject>Female</subject><subject>Hematology</subject><subject>Humans</subject><subject>Leukemia</subject><subject>Leukemia, Promyelocytic, Acute - diagnosis</subject><subject>Leukemia, Promyelocytic, Acute - mortality</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Models, Theoretical</subject><subject>Mortality - trends</subject><subject>Oncology</subject><subject>Original Article</subject><subject>Predictive Value of Tests</subject><subject>Prospective Studies</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>0939-5555</issn><issn>1432-0584</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1vFSEUhonR2Gv1B7gxJG7cjPIxDMPSNLU1aeJCXRMuHCrtDFyBaTMu_eUyudUYE9mQcJ7zcOBF6CUlbykh8l0hhEnZESo7TtTQiUdoR3vOOiLG_jHaEcVVJ9o6Qc9KuSGEsrFnT9EJG0fGiRA79PPce7A13IW64uSxwXNywQdw-LOJP3AO5XY7ggn7lDGYPK3Yganf8CGDC601RRwiPpgaINaC70OrRbjfuGCuYyrNZexSoXWkeYUp2bUGiydYbmEO5jl64s1U4MXDfoq-fjj_cnbZXX26-Hj2_qqzXLLaCWrIXnkrJR9GRj0M7XVGDfuR986ZUVEDsleKCSYdt36gkvTcDCAJJw4UP0Vvjt42xvcFStVzKBamyURIS9FUtU_kVCjR0Nf_oDdpybFN1yhBFZVq3IT0SNmcSsng9SGH2eRVU6K3gPQxIN0C0ltAejO_ejAv-xncn47fiTSAHYHSSvEa8l9X_9f6C7JonEc</recordid><startdate>20171101</startdate><enddate>20171101</enddate><creator>Lou, Yinjun</creator><creator>Ma, Yafang</creator><creator>Sun, Jianai</creator><creator>Suo, Sansan</creator><creator>Tong, Hongyan</creator><creator>Qian, Wenbin</creator><creator>Mai, Wenyuan</creator><creator>Meng, Haitao</creator><creator>Jin, Jie</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope></search><sort><creationdate>20171101</creationdate><title>Effectivity of a modified Sanz risk model for early death prediction in patients with newly diagnosed acute promyelocytic leukemia</title><author>Lou, Yinjun ; Ma, Yafang ; Sun, Jianai ; Suo, Sansan ; Tong, Hongyan ; Qian, Wenbin ; Mai, Wenyuan ; Meng, Haitao ; Jin, Jie</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-51a0b9fc7736821fe6939a96b834dda891ae74992527d3cf617043a6e7030de93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Aged</topic><topic>Female</topic><topic>Hematology</topic><topic>Humans</topic><topic>Leukemia</topic><topic>Leukemia, Promyelocytic, Acute - diagnosis</topic><topic>Leukemia, Promyelocytic, Acute - mortality</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Models, Theoretical</topic><topic>Mortality - trends</topic><topic>Oncology</topic><topic>Original Article</topic><topic>Predictive Value of Tests</topic><topic>Prospective Studies</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lou, Yinjun</creatorcontrib><creatorcontrib>Ma, Yafang</creatorcontrib><creatorcontrib>Sun, Jianai</creatorcontrib><creatorcontrib>Suo, Sansan</creatorcontrib><creatorcontrib>Tong, Hongyan</creatorcontrib><creatorcontrib>Qian, Wenbin</creatorcontrib><creatorcontrib>Mai, Wenyuan</creatorcontrib><creatorcontrib>Meng, Haitao</creatorcontrib><creatorcontrib>Jin, Jie</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of hematology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lou, Yinjun</au><au>Ma, Yafang</au><au>Sun, Jianai</au><au>Suo, Sansan</au><au>Tong, Hongyan</au><au>Qian, Wenbin</au><au>Mai, Wenyuan</au><au>Meng, Haitao</au><au>Jin, Jie</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effectivity of a modified Sanz risk model for early death prediction in patients with newly diagnosed acute promyelocytic leukemia</atitle><jtitle>Annals of hematology</jtitle><stitle>Ann Hematol</stitle><addtitle>Ann Hematol</addtitle><date>2017-11-01</date><risdate>2017</risdate><volume>96</volume><issue>11</issue><spage>1793</spage><epage>1800</epage><pages>1793-1800</pages><issn>0939-5555</issn><eissn>1432-0584</eissn><abstract>Early death is the main obstacle for the cure of patients with acute promyelocytic leukemia (APL). We have analyzed risk factors of early death from 526 consecutive newly diagnosed APL patients between 2004 and 2016. The overall incidence of early death was 7.2% (38/526). The peak hazard of early death occurred in the first 0–3 days. Multivariate logistic analysis demonstrated white blood cell (WBC) counts [odds ratio (OR) = 1.039; 95% confidence interval (CI): 1.024–1.055;
P
< 0.001], age (OR = 1.061; 95% CI: 1.025–1.099;
P
= 0.001) and platelet counts (OR = 0.971; 95% CI: 0.944–0.999;
P
= 0.038) were independent risk factors for early death. Furthermore, receiver-operator characteristic (ROC) curve analyses revealed a simple WBC/platelet ratio was significantly more accurate in predicting early death [areas under the ROC curve (AUC) = 0.842, 95% CI: 0.807–0.872) than WBC counts (AUC = 0.793; 95% CI: 0.756–0.827) or Sanz score (AUC = 0.746; 95% CI: 0.706–0.783). We stratified APL patients into four risk subgroups: low risk (WBC ≤ 10 × 10
9
/L, platelet >40 × 10
9
/L), intermediate risk (WBC/platelet <0.2 and age ≤ 60, not in low risk), high risk (WBC/platelet ≥0.2 or age > 60, not in low and ultra-high risk) and ultra-high risk (WBC > 50 × 10
9
/L), the early death rates were 0, 0.6, 12.8, and 41.2%, respectively. In conclusion, we proposed a modified Sanz risk model as a useful predictor of early death risk in patients with APL.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>28823055</pmid><doi>10.1007/s00277-017-3096-5</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Female Hematology Humans Leukemia Leukemia, Promyelocytic, Acute - diagnosis Leukemia, Promyelocytic, Acute - mortality Male Medicine Medicine & Public Health Middle Aged Models, Theoretical Mortality - trends Oncology Original Article Predictive Value of Tests Prospective Studies Retrospective Studies Risk Factors |
| title | Effectivity of a modified Sanz risk model for early death prediction in patients with newly diagnosed acute promyelocytic leukemia |
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