Establishment of Definitions and Review Process for Consistent Adjudication of Cause-specific Mortality after Allogeneic Unrelated-donor Hematopoietic Cell Transplantation

Theresa Hahn, Lara E. Sucheston-Campbell, Leah Preus, Xiaochun Zhu, John A. Hansen, Paul J. Martin, Li Yan, Song Liu, Stephen Spellman, David Tritchler, Alyssa Clay, Kenan Onel, Marcelo Pasquini, Philip L. McCarthy

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Clinical trials commonly use adjudication committees to refine endpoints, but observational research or genome-wide association studies rarely do. Our goals were to establish definitions of cause-specific death after unrelated-donor allogeneic hematopoietic cell transplantation (URD-HCT), to estimate discordance between reported and adjudicated cause-specific death, and to identify factors contributing to inconsistency in cause-specific death determination. A consensus panel adjudicated cause-specific death in 1484 patients who died within 1 year after HCT, derived from 3532 acute leukemia or myelodysplasia patients after URD-HCT from 2000 to 2011 reported by 151 US transplant centers to the Center for International Blood and Marrow Transplant Research. Deaths were classified as disease-related or transplant-related. The panel agreed with >99% of deaths reported by centers as disease-related and 80% reported as transplant-related. Year of transplant (cohort effect) and disease status significantly influenced agreement between the panel and centers. Sensitivity analysis of deaths < 100 days post-transplant yielded the lowest agreement between the panel and centers for myelodysplastic syndrome patients. Standard predefined criteria for adjudicating cause-specific death led to consistent application to similar clinical scenarios and clearer delineation of cause-specific death categories. Other studies of competing events such as cancer-specific versus treatment-related mortality would benefit from our results. Our detailed algorithm should result in more consistent reporting of cause-specific death by centers.

Original languageEnglish
Pages (from-to)1679-1686
Number of pages8
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number9
DOIs
StatePublished - 1 Sep 2015
Externally publishedYes

Keywords

  • Acute leukemia
  • Adjudication
  • Allogeneic HCT
  • Cause-specific mortality

Fingerprint

Dive into the research topics of 'Establishment of Definitions and Review Process for Consistent Adjudication of Cause-specific Mortality after Allogeneic Unrelated-donor Hematopoietic Cell Transplantation'. Together they form a unique fingerprint.

Cite this