Objective:

To identify independent risk factors for delayed erythroid hematopoietic reconstitution (DEHR) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) and develop a predictive model.

Approach:

• Study Design: A retrospective study involving 165 patients who underwent allo-HSCT, categorized into DEHR and non-DEHR groups.
• Data Analysis: Utilized univariate and multivariate logistic regression analyses to identify risk factors and constructed a prediction model.
• Model Evaluation: Assessed model discrimination, calibration, and clinical utility using AUC, calibration curves, Hosmer-Lemeshow tests, and decision curve analysis.

Key Findings:

• Ferritin level before transplantation (OR = 1.001, 95% CI 1.000-1.001) is an independent risk factor for DEHR.
• Severity of anemia before transplantation (OR = 3.740, 95% CI 1.115-12.541) is a significant risk factor.
• Compatibility of donor and recipient ABO blood type (OR = 3.283, 95% CI 1.262-8.540) is associated with DEHR.
• The model's AUC was 0.835 (95% CI: 0.759–0.910), indicating good predictive performance.

Interpretation:

The constructed nomogram based on identified risk factors demonstrates potential for predicting DEHR after allo-HSCT.

Limitations:

• Retrospective design may introduce selection bias.
• Single-center study limits generalizability of findings.

Conclusion:

The study provides a reference for early identification of high-risk individuals for DEHR post-allo-HSCT.