The hematopoietic cell transplantation‐specific comorbidity index (HCT‐CI) is an outcome predictor for partially matched related donor transplantation

Abstract

To validate the predictive ability of the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) on the outcome of hematopoietic stem cell transplantation (HSCT) patients who received transplants from partially matched related donors (PMRD), a total of 526 patients who received PMRD HSCT between January 2006 and December 2009 at the Institute of Hematology, Peking University were enrolled. Patients were grouped according to their HCT-CI score; 31.0%, 31.4%, and 37.6% of patients had HCT-CI scores of 0, 1-2, and !3, respectively. Patients with HCT-CI scores of !3 had a significantly poorer 2-year overall survival (OS) than patients with HCT-CI scores of 0-2 (54.55% vs. 78.05%, P < 0.001). In addition, patients with HCT-CI scores of !3 had a significantly higher 2-year cumulative incidence of relapse and nonrelapse mortality (NRM) than patients with scores of 0-2 (relapse: 23.23% vs. 11.59%, P < 0.001; NRM: 34.30% vs. 15.93%, P < 0.001). HCT-CI scores of <3 were associated with better OS, less relapse, and lower NRM in multivariate analysis. Patients who had high comorbidity scores as well as high-risk disease had the poorest outcomes. Therefore, we found that HCT-CI is associated with the outcomes of PMRD HSCT and we should closely monitor patients with a high comorbidity burden. Am. J. Hematol. 88:497-502, 2013. V C 2013 Wiley Periodicals, Inc.

Haploidentical hematopoietic stem cell transplantation in adults with Philadelphia‐negative acute lymphoblastic leukemia: No difference in the high‐ and low‐risk groups

“…In the present study, an HCT-CI score of 3 had a trend of increasing NRM and was an independent risk factor for worse survival, which is in keeping with previous studies. 31,32 Our results confirmed that HCT-CI might be a useful tool to assess risk and guide counseling in Ph-negative ALL CR1 patients who are in need of haplo-HSCT. However, the ratio of patients with HCT-CI scores of 3 was comparable between lowand high-risk groups, which suggests that pre-HSCT comorbidity burden was comparable between the groups in this study.…”

Chronic GVHD induced GVL effect after unmanipulated haploidentical hematopoietic SCT for AML and myelodysplastic syndrome

“…Second, we confirmed that pre-HSCT comorbidities strongly predicted NRM after haplo-HSCT. 29 However, the ratio of patients with hematopoietic cell transplantation-specific comorbidity index scores of ⩾ 3 was comparable between the cGVHD and non-cGVHD groups, which suggested that the pre-HSCT comorbidity burden was comparable between the groups in this study.…”

EBMT risk score can predict the outcome of leukaemia after unmanipulated haploidentical blood and marrow transplantation

“…Second, based on our previous study, the haematopoietic cell transplantation-specific comorbidity index (HCT-CI) can also predict outcomes after unmanipulated HBMT. 34 Barba et al 35 suggest that combined HCT-CI and EBMT risk score can better stratify high-risk patients undergoing reduced toxicity allo-HSCT. In our transplantation system, whether the haplo-EBMT risk score and the HCT-CI can be combined to predict outcomes is still unknown, and the methods necessary to properly use these indexes to better stratify patients undergoing haploidentical HSCT require further research.…”