UNASSIGNED: In the field of hematopoietic stem cell transplantation, the common approach is to focus outcome analyses on time to relapse and @entity204 , without assessing the impact of post-transplant interventions. We investigated whether a multi-state model would give insight into the events after transplantation in a cohort of @entity1 who were transplanted using a strategy including scheduled donor lymphocyte infusions. Seventy-eight consecutive @entity1 who underwent myeloablative T-cell depleted allogeneic stem cell transplantation for @entity3052 or @entity2590 were studied. We constructed a multi-state model to analyze the impact of donor lymphocyte infusion and @entity2132 on the probabilities of relapse and non-relapse mortality over time. Based on this model we introduced a new measure for outcome after transplantation which we called "treatment success" being alive without relapse and immunosuppression for @entity2132 . All relevant clinical events were implemented into the multi-state model and were denoted treatment success or failure (either transient or permanent). Both relapse and non-relapse mortality were causes of failure of comparable magnitude. Whereas relapse was the dominant cause of failure from the transplantation state, its rate was reduced after @entity2132 and especially after donor lymphocyte infusion. The long-term probability of treatment success was approximately 40%. This probability was increased after donor lymphocyte infusion. Our multi-state model helps to interpret the impact of post-transplantation interventions and clinical events on failure and treatment success, thus extracting more information from observational data.

Multi-state analysis illustrates treatment success after stem cell transplantation for XXXX followed by donor lymphocyte infusion.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2590 :: ('MESH:D009190', 'Disease') :: ['myelodysplastic syndrome'] @entity3052 :: ('MESH:D015470', 'Disease') :: ['acute myeloid leukemia'] @entity2132 :: ('MESH:D006086', 'Disease') :: ['graft-versus-host disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death']
@entity3052 :: (MESH:D015470,Disease) :: ['acute myeloid leukemia']
