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EnglishPredicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p < 0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure.
Olivieri, J., Attolico, I., Nuccorini, R., Pascale, S. P., Chiarucci, M., Poiani, M., Corradini, P., Farina, L., Gaidano, G., Nassi, L., Sica, S., Piccirillo, N., Pioltelli, P. E., Martino, M., Moscato, T., Pini, M., Zallio, F., Ciceri, F., Marktel, S., Mengarelli, A., Musto, P., Capria, S., Merli, F., Codeluppi, K., Mele, G., Lanza, F., Specchia, G., Pastore, D., Milone, G., Saraceni, F., Di Nardo, E., Perseghin, P., Olivieri, A., Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score, <<BONE MARROW TRANSPLANTATION>>, 2018; 53 (4): 461-473. [doi:10.1038/s41409-017-0051-y] [http://hdl.handle.net/10807/169063]
| Titolo: | Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score |
| Parole Chiave: | Adolescent Adult Aged Area Under Curve Child Child, Preschool Female Hematopoietic Stem Cell Mobilization Humans Male Middle Aged Multiple Myeloma Retrospective Studies Risk Factors Young Adult Patient Selection Predictive Value of Tests |
| Volume: | 53 |
| Fascicolo: | 4 |
| Pagina iniziale: | 461 |
| Pagina finale: | 473 |
| Digital Object Identifier (DOI): | http://dx.doi.org/10.1038/s41409-017-0051-y |
| Data di pubblicazione: | 2018 |
| Tipologia driver: | info:eu-repo/semantics/article |
| Full-text (pubblici): | none |
| Anno Fascicolo: | 2018 |
| Citazione: | Olivieri, J., Attolico, I., Nuccorini, R., Pascale, S. P., Chiarucci, M., Poiani, M., Corradini, P., Farina, L., Gaidano, G., Nassi, L., Sica, S., Piccirillo, N., Pioltelli, P. E., Martino, M., Moscato, T., Pini, M., Zallio, F., Ciceri, F., Marktel, S., Mengarelli, A., Musto, P., Capria, S., Merli, F., Codeluppi, K., Mele, G., Lanza, F., Specchia, G., Pastore, D., Milone, G., Saraceni, F., Di Nardo, E., Perseghin, P., Olivieri, A., Predicting failure of hematopoietic stem cell mobilization before it starts: The predicted poor mobilizer (pPM) score, <<BONE MARROW TRANSPLANTATION>>, 2018; 53 (4): 461-473. [doi:10.1038/s41409-017-0051-y] [http://hdl.handle.net/10807/169063] |
| Lingua: | Inglese |
| Editore: | Nature Publishing Group |
| Tipo: | Articolo su rivista scientifica / specializzata |
| Numero di pagine: | 13 |
| Lingua 1 parole chiave: | Inglese |
| Tipo di contributo MIUR su rivista: | Articolo in rivista |
| Autori: | |
| Rivista: | |
| Settore Scientifico Disciplinare: | Settore MED/15 - MALATTIE DEL SANGUE |
| Autori: | Olivieri, J.; Attolico, I.; Nuccorini, R.; Pascale, S. P.; Chiarucci, M.; Poiani, M.; Corradini, P.; Farina, L.; Gaidano, G.; Nassi, L.; Sica, S.; Piccirillo, N.; Pioltelli, P. E.; Martino, M.; Moscato, T.; Pini, M.; Zallio, F.; Ciceri, F.; Marktel, S.; Mengarelli, A.; Musto, P.; Capria, S.; Merli, F.; Codeluppi, K.; Mele, G.; Lanza, F.; Specchia, G.; Pastore, D.; Milone, G.; Saraceni, F.; Di Nardo, E.; Perseghin, P.; Olivieri, A. |
| Tipologia MIUR: | 262 |
| Area tematica ERC: | LS7 - Diagnostic tools, therapies and public health: aetiology, diagnosis and treatment of disease, public health, epidemiology, pharmacology, clinical medicine, regenerative medicine, medical ethics |
| Codice identificativo ISI: | WOS:000429913700012 |
| Codice identificativo Scopus: | 2-s2.0-85040329296 |
| Abstract: | Predicting mobilization failure before it starts may enable patient-tailored strategies. Although consensus criteria for predicted PM (pPM) are available, their predictive performance has never been measured on real data. We retrospectively collected and analyzed 1318 mobilization procedures performed for MM and lymphoma patients in the plerixafor era. In our sample, 180/1318 (13.7%) were PM. The score resulting from published pPM criteria had sufficient performance for predicting PM, as measured by AUC (0.67, 95%CI: 0.63-0.72). We developed a new prediction model from multivariate analysis whose score (pPM-score) resulted in better AUC (0.80, 95%CI: 0.76-0.84, p < 0001). pPM-score included as risk factors: increasing age, diagnosis of NHL, positive bone marrow biopsy or cytopenias before mobilization, previous mobilization failure, priming strategy with G-CSF alone, or without upfront plerixafor. A simplified version of pPM-score was categorized using a cut-off to maximize positive likelihood ratio (15.7, 95%CI: 9.9-24.8); specificity was 98% (95%CI: 97-98.7%), sensitivity 31.7% (95%CI: 24.9-39%); positive predictive value in our sample was 71.3% (95%CI: 60-80.8%). Simplified pPM-score can "rule in" patients at very high risk for PM before starting mobilization, allowing changes in clinical management, such as choice of alternative priming strategies, to avoid highly likely mobilization failure. |
| Numero degli autori: | 33 |
| Appare nelle tipologie: | Articolo in rivista, Nota a sentenza |
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