Modern strategies to reduce non-relapse mortality in allogeneic hematopoietic cell transplantation in the modern era: improving donor selection and patient selection
[eng] INTRODUCTION: Allogeneic hematopoietic cell transplantation (alloHCT) is a lifesaving procedure for several oncological and non-oncological diseases. However, the higher mortality related to the toxicity of the transplant limits the curative potential of such a therapeutic strategy. The improv...
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| Tipo de documento: | tese |
| Estado: | Versão publicada |
| Data de publicação: | 2025 |
| País: | España |
| Recursos: | Universidad de Barcelona |
| Repositório: | Dipòsit Digital de la UB |
| OAI Identifier: | oai:diposit.ub.edu:2445/221499 |
| Acesso em linha: | https://hdl.handle.net/2445/221499 http://hdl.handle.net/10803/694628 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Hematologia Limfomes Immunologia de la trasplantació Hematology Lymphomas Transplantation immunology |
| Resumo: | [eng] INTRODUCTION: Allogeneic hematopoietic cell transplantation (alloHCT) is a lifesaving procedure for several oncological and non-oncological diseases. However, the higher mortality related to the toxicity of the transplant limits the curative potential of such a therapeutic strategy. The improvement of pre-transplant factors which could be modified from the physician have the potential to reduce the toxicity and increase the survival rates without complex specific interventions. A better selection of donors and patients represents a key aspect in decreasing transplant mortality. HYPOTHESIS: First study: we hypothesized that when using post-transplant cyclophosphamide (PTCy) for graft-versus-host disease (GVHD) prophylaxis, the use of a matched-unrelated donor (MUD) or of a haploidentical one would have same clinical outcomes. Second study: we hypothesized that a prognostic score made through the use of artificial- intelligence methods, would be superior to standard scores in terms of clinical outcomes predicticion. OBJECTIVES: The aim of this project is to take advantage of international networks and registry-derived data to improve the evaluation of donor and patient selection. 1) in the first study, we will perform a comparison between the use of a MUD and a haploidentical donor in the setting of patients affected by lymphoproliferative diseases who have received an allogeneic hematopoietic cell transplantation when using PTCy as GVHD prophylaxis. The two cohorts will be compared in terms of the following outcomes: overall survival (OS), progression-free survival (PFS), non-relapse mortality (NRM), relapse incidence/prograssion of disease (RI/POD), acute GVHD, chronic GVHD. 2) in the second study, we will create a newer personalized prognostic score which will be built through the use of registry-derived big data and will allow to calculate survival outcomes for alloHCT. Six artificial-intelligence derived scores will be compared to standard logisitic regression analysis in terms of overall mortality (OM) and NRM prediction capacity. The results will be compared, and the best method will be used to generate survival prediction across the study population. |
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