The hematopoietic cell transplantation comorbidity index is a predictor of early death and survival in adult acute myeloid leukemia patients

Savić, Aleksandar; Kvrgic, Vanja; Rajić, Nebojša; Urošević, Ivana; Kovačević, Dražen; Perčić, Ivanka; Popovic, Stevan

doi:10.1016/j.leukres.2011.11.021

Cited by 43 publications

(39 citation statements)

References 8 publications

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“…Most widely used is the HCT-CI score published by Sorror et al, although its impact in different scenarios remains unclear as shown by a number of different studies. [26][27][28] Our data suggested marginal contribution of the HCT-CI score for recipients of allografts in CR2. Assessment of the impact of pre-existing comorbidities on OS and RR is of particular importance for older transplant recipients that are usually prepared with RIC regimens 10,13 resulting in a higher RR.…”

Section: Discussionmentioning

confidence: 64%

Duration of first remission, hematopoietic cell transplantation-specific comorbidity index and patient age predict survival of patients with AML transplanted in second CR

Michelis

Atenafu

Gupta

et al. 2013

Bone Marrow Transplant

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Allo-SCT is potentially curative for patients with AML. Patients transplanted in CR2 tend to experience inferior survival compared with those in CR1. We retrospectively investigated the impact of pretransplant variables on the outcome of patients transplanted with AML in CR2. Ninety-four patients with AML in CR2 received a transplant between 1999 and 2011 with myeloablative (MA, n ¼ 65) or reduced-intensity conditioning regimens (RIC, n ¼ 29). Variables investigated included cytogenetic risk at diagnosis (SWOG), hematopoietic cell transplantation-specific comorbidity index (HCT-CI), CMV status, duration of CR1 and age. Median age of all patients was 47 years (range 18-70). Multivariable analysis for OS identified three prognostically significant categories: a favorable risk group included patients with duration of CR1 X6 months, age o55 years and HCT-CI score 0-3, an intermediate risk group with duration of CR1 X6 months, age o55 years and HCT-CI score 4-5 and a high-risk group with duration of CR1 o6 months or age X55 years (P ¼ 0.0001) with 5-year survivals of 53%, 31% and 6%, respectively. Acute and chronic GVHD did not influence this risk stratification. The stated risk factors discriminate patients with different OS and may assist in decision making for allo-SCT.

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Section: Discussionmentioning

confidence: 64%

Duration of first remission, hematopoietic cell transplantation-specific comorbidity index and patient age predict survival of patients with AML transplanted in second CR

Michelis

Atenafu

Gupta

et al. 2013

Bone Marrow Transplant

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“…20,56,57 Comorbidity did not independently predict survival in our study, although it was a risk factor for both treatment-related mortality and survival in other studies. 48,68,69 There are several potential explanations for this discordance. First, our patient population was already highly selected, with a low prevalence of major comorbid conditions known to complicate induction therapy.…”

Section: Discussionmentioning

confidence: 99%

Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia

Klepin

Geiger

Tooze

et al. 2013

Blood

360

274

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“…7 The prognostic value of the HCT-CI score for allogeneic HCT in AML has been demonstrated in a number of studies. 8,9 However, a pre-transplant scoring system specific for AML that incorporates significant patient, disease and transplantrelated parameters has not been developed.…”

Section: Introductionmentioning

confidence: 99%

Patient age, remission status and HCT-CI in a combined score are prognostic for patients with AML undergoing allogeneic hematopoietic cell transplantation in CR1 and CR2

Michelis

Messner

Atenafu

et al. 2015

Bone Marrow Transplant

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For AML, older age, advanced disease and increased hematopoietic cell transplant comorbidity index (HCT-CI) are associated with worse prognosis following allogeneic hematopoietic cell transplantation (HCT). This single-center retrospective study investigated the influence of pre-transplant characteristics on outcomes of 387 patients undergoing allogeneic HCT for AML in CR1 and CR2. The multivariable analysis model for overall survival (OS) included age (hazard ratio (HR) = 2.24 for ages 31-64 years and HR = 3.23 for age ⩾ 65 years compared with age ⩽ 30 years, P = 0.003), remission status (HR = 1.49 for CR2 compared with CR1, P = 0.005) and HCT-CI score (HR = 1.47 for ⩾ 3 compared with o 3, P = 0.005). Transplant year was significantly associated with OS (P = 0.001) but this did not influence the model. A weighted score was developed with age ⩽ 30, CR1 and HCT-CI score o 3 receiving 0 points each, and CR2 and HCT-CI score ⩾ 3 receiving 1 point each. Ages 31-64 received 2 points, age ⩾ 65 received 3 points. Scores were grouped as follows: scores 0-1 (low risk, n = 36), score 2 (intermediate-low risk, n = 147), score 3 (intermediate-high risk, n = 141) and scores 4-5 (high risk, n = 63) with 3-year OS of 71%, 55%, 42% and 29% for scores 0-1, 2, 3 and 4-5, respectively (P o 0.0001). The score predicted nonrelapse mortality (P = 0.03) but not cumulative incidence of relapse (P = 0.18). This model should be validated for the pre-HCT assessment of AML patients in CR1 and CR2.

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The hematopoietic cell transplantation comorbidity index is a predictor of early death and survival in adult acute myeloid leukemia patients

Cited by 43 publications

References 8 publications

Duration of first remission, hematopoietic cell transplantation-specific comorbidity index and patient age predict survival of patients with AML transplanted in second CR

Duration of first remission, hematopoietic cell transplantation-specific comorbidity index and patient age predict survival of patients with AML transplanted in second CR

Geriatric assessment predicts survival for older adults receiving induction chemotherapy for acute myelogenous leukemia

Patient age, remission status and HCT-CI in a combined score are prognostic for patients with AML undergoing allogeneic hematopoietic cell transplantation in CR1 and CR2

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