Pan Lin, Wei Zhenbin, Xie Yanni, Gan Zhaoping, Xiao Hongwen, Liu Lianjin, Shi Lingling, Zhang Zhongming, Wu Meiqing, Chen Yinghua, Liu Yanye, Zhou Xuemei, Li Chan, Qin Chunjie, Lai Yongrong, Liu Rongrong
The First Affiliated Hospital of Guangxi Medical University, Nanning, P. R. China.
NHC Key Laboratory of Thalassemia Medicine, Nanning, Guangxi, P. R. China.
SAGE Open Med. 2025 Jul 29;13:20503121251360132. doi: 10.1177/20503121251360132. eCollection 2025.
Cytomegalovirus infection is a common complication following hematopoietic stem cell transplantation that significantly influences clinical outcomes.
To develop and validate a predictive model for cytomegalovirus infection risk in patients with β-thalassemia major undergoing hematopoietic stem cell transplantation.
Retrospective cohort study.
Clinical data from 291 β-thalassemia major patients undergoing hematopoietic stem cell transplantation were retrospectively analyzed. Independent risk factors identified via univariate and multivariate logistic regression analyses formed the basis of a predictive nomogram. The model's performance was evaluated by the concordance index (C-index), receiver operating characteristic curves, calibration plots, and decision curve analysis. Internal validation was performed using bootstrap resampling, and external validation was conducted with an independent cohort of 84 patients from another center.
Three independent predictors of cytomegalovirus infection were identified: serum albumin levels, donor type, and grade III-IV acute graft-versus-host disease. A nomogram incorporating these predictors was established, demonstrating good discriminative ability (C-index: 0.745; 95% CI: 0.684-0.807). Internal and external validations yielded C-indices of 0.746 and 0.649, respectively. Receiver operating characteristic analysis showed an area under the curve of 0.745 in the training cohort and 0.649 in the validation cohort.
We developed and validated a reliable predictive model for assessing cytomegalovirus infection risk after hematopoietic stem cell transplantation in β-thalassemia major patients. This scoring system offers clinicians a practical tool for early risk stratification and intervention.
巨细胞病毒感染是造血干细胞移植后的常见并发症，对临床结局有显著影响。
建立并验证重型β地中海贫血患者造血干细胞移植后巨细胞病毒感染风险的预测模型。
回顾性队列研究。
回顾性分析291例接受造血干细胞移植的重型β地中海贫血患者的临床资料。通过单因素和多因素逻辑回归分析确定的独立危险因素构成了预测列线图的基础。通过一致性指数（C指数）、受试者工作特征曲线、校准图和决策曲线分析评估模型的性能。使用自助重采样进行内部验证，并对来自另一个中心的84例患者的独立队列进行外部验证。
确定了巨细胞病毒感染的三个独立预测因素：血清白蛋白水平、供体类型和III-IV级急性移植物抗宿主病。建立了包含这些预测因素的列线图，显示出良好的判别能力（C指数：0.745；95%CI：0.684-0.807）。内部和外部验证的C指数分别为0.746和0.649。受试者工作特征分析显示，训练队列中的曲线下面积为0.745，验证队列中的曲线下面积为0.649。
我们建立并验证了一个可靠的预测模型，用于评估重型β地中海贫血患者造血干细胞移植后巨细胞病毒感染风险。该评分系统为临床医生提供了一个用于早期风险分层和干预的实用工具。
