Analysis of Pleural Effusion After Allogeneic Hematopoietic Stem Cell Transplant Using Multistate Models

• Activity Number: 265
• Type: Contributed
• Date/Time: Monday, August 1, 2016 : 2:00 PM to 3:50 PM
• Sponsor: Section on Medical Devices and Diagnostics
• Author(s): Joohyoung Lee* and Dipenkumar Modi and Hyejeong Jang and Joseph Uberti and Seongho Kim
• Companies: Karmanos Cancer Institute and Wayne State University and Karmanos Cancer Institute and Wayne State University and Karmanos Cancer Institute
• Keywords: Multistate model ; HSCT ; Pelural effusion ; GVHD

Abstract

Pleural effusion is a severe complication that often occurs after allogeneic hematopoietic stem cell transplant (aHSCT), but its incidence, risk factors, and mortality still remains unclear. Many patients develop pleural effusion during the first 100 days after aHSCT and graft-versus-host disease (GVHD) occurs either before or after the development of PE, implying that the occurrence order of pleural effusion and GVHD (i.e., pleural effusionafter GVHD vs. GVHD after pleural effusion) would influence on the incidence, risk factors and mortality of pleural effusion. One can use competing risk models to evaluate these values, but neither method is able to incorporate the occurrence order of incidence into the model. To resolve this difficulty, we instead developed a multistate model, which can not only reflect the occurrence order of pleural effusion and GVHD but also describe several possible events and event-related dependences. The developed multistate model was applied to a retrospective study of 618 patients, including several covariates (age, race, human leukocyte antigen match, disease risk status, donor, comorbidity).