Synapse - 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

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 Journal Article

Authors:	Barba, P.; Ratan, R.; Cho, C.; Ceberio, I.; Hilden, P.; Devlin, S. M.; Maloy, M. A.; Barker, J. N.; Castro-Malaspina, H.; Jakubowski, A. A.; Koehne, G.; Papadopoulos, E. B.; Ponce, D. M.; Sauter, C.; Tamari, R.; van den Brink, M. R. M.; Young, J. W.; O'Reilly, R. J.; Giralt, S. A.; Perales, M. A.
Article Title:	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. © 2017 The American Society for Blood and Marrow Transplantation
Keywords:	comorbidity; t cell depletion; allogeneic hematopoietic cell transplantation; hct-ci
Journal Title:	Biology of Blood and Marrow Transplantation
Volume:	23
Issue:	1
ISSN:	1083-8791
Publisher:	Elsevier Inc.
Date Published:	2017-01-01
Start Page:	67
End Page:	74
Language:	English
DOI:	10.1016/j.bbmt.2016.10.017
PROVIDER:	scopus
PMCID:	PMC5182101
PUBMED:	27789361
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-85006364852&doi=10.1016%2fj.bbmt.2016.10.017&partnerID=40&md5=88487da769e1886d8507d2797003d284
Notes:	Article -- Export Date: 3 January 2017 -- Source: Scopus