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Hematopoietic Cell Transplantation Comorbidity Index Predicts Outcomes in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Receiving CD34+ Selected Grafts for Allogeneic Hematopoietic Cell Transplantation.


ABSTRACT: To evaluate the association between the hematopoietic cell transplantation-comorbidity index (HCT-CI) and the recently developed age-adjusted HCT-CI (HCT-CI/age) and transplant outcomes in the setting of CD34-selected allogeneic HCT, we analyzed a homogeneous population of patients undergoing allogeneic HCT with CD34-selected grafts for acute myeloid leukemia and myelodysplastic syndrome (n?=?346). Median HCT-CI and HCT-CI/age scores were 2 (percentile 25 to 75, 1 to 4) and 3 (percentile 25 to 75, 1 to 5), respectively. Higher HCT-CI and HCT-CI/age scores were associated with higher nonrelapse mortality (NRM) and lower overall survival (OS). The HCT-CI distinguished 2 risk groups (0 to 2 versus ?3), whereas, with the HCT-CI/age, there was a progressive increase in NRM and decrease in OS with increasing scores in all 4 groups (0 versus 1 to 2 versus 3 to 4 versus ?5). Higher scores in both models were associated with lower chronic graft-versus-host disease relapse-free survival but not with higher relapse. Both models showed a promising predictive accuracy for NRM (c-?= .616 for HCT-CI and c-?=?.647 for HCT-CI/age). In conclusion, the HCT-CI and HCT-CI/age predict transplant outcomes in CD34-selected allo-HCT, including NRM, OS, and chronic graft-versus-host disease relapse-free survival and may be used to select appropriate patients for this approach.

SUBMITTER: Barba P 

PROVIDER: S-EPMC5182101 | biostudies-literature | 2017 Jan

REPOSITORIES: biostudies-literature

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Hematopoietic Cell Transplantation Comorbidity Index Predicts Outcomes in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Receiving CD34<sup>+</sup> Selected Grafts for Allogeneic Hematopoietic Cell Transplantation.

Barba Pere P   Ratan Ravin R   Cho Christina C   Ceberio Izaskun I   Hilden Patrick P   Devlin Sean M SM   Maloy Molly A MA   Barker Juliet N JN   Castro-Malaspina Hugo H   Jakubowski Ann A AA   Koehne Guenther G   Papadopoulos Esperanza B EB   Ponce Doris M DM   Sauter Craig C   Tamari Roni R   van den Brink Marcel R M MRM   Young James W JW   O'Reilly Richard J RJ   Giralt Sergio A SA   Perales Miguel-Angel MA  

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 20161024 1


To evaluate the association between the hematopoietic cell transplantation-comorbidity index (HCT-CI) and the recently developed age-adjusted HCT-CI (HCT-CI/age) and transplant outcomes in the setting of CD34-selected allogeneic HCT, we analyzed a homogeneous population of patients undergoing allogeneic HCT with CD34-selected grafts for acute myeloid leukemia and myelodysplastic syndrome (n = 346). Median HCT-CI and HCT-CI/age scores were 2 (percentile 25 to 75, 1 to 4) and 3 (percentile 25 to 7  ...[more]

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