The Simplified Comorbidity Index predicts non-relapse mortality in reduced-intensity conditioning allogeneic haematopoietic cell transplantation Journal Article
| Authors: | Elias, S.; Brown, S.; Devlin, S. M.; Barker, J. N.; Cho, C.; Chung, D. J.; Dahi, P. B.; Giralt, S.; Gyurkocza, B.; Jakubowski, A. A.; Lahoud, O. B.; Landau, H.; Lin, R. J.; Papadopoulos, E. B.; Politikos, I.; Ponce, D. M.; Scordo, M.; Shaffer, B. C.; Shah, G. L.; Tamari, R.; Young, J. W.; Perales, M. A.; Shouval, R. |
| Article Title: | The Simplified Comorbidity Index predicts non-relapse mortality in reduced-intensity conditioning allogeneic haematopoietic cell transplantation |
| Abstract: | Comorbidity assessment before allogeneic haematopoietic cell transplantation (allo-HCT) is essential for estimating non-relapse mortality (NRM) risk. We previously developed the Simplified Comorbidity Index (SCI), which captures a small number of ‘high-yield’ comorbidities and older age. The SCI was predictive of NRM in myeloablative CD34-selected allo-HCT. Here, we evaluated the SCI in a single-centre cohort of 327 patients receiving reduced-intensity conditioning followed by unmanipulated allografts from HLA-matched donors. Among the SCI factors, age above 60, mild renal impairment, moderate pulmonary disease and cardiac disease were most frequent. SCI scores ranged from 0 to 8, with 39%, 20%, 20% and 21% having scores of 0–1, 2, 3 and ≥4 respectively. Corresponding cumulative incidences of 3-year NRM were 11%, 16%, 22% and 27%; p = 0.03. In multivariable models, higher SCI scores were associated with incremental risks of all-cause mortality and NRM. The SCI had an area under the receiver operating characteristic curve of 65.9%, 64.1% and 62.9% for predicting 1-, 2- and 3-year NRM versus 58.4%, 60.4% and 59.3% with the haematopoietic cell transplantation comorbidity index. These results demonstrate for the first time that the SCI is predictive of NRM in patients receiving allo-HCT from HLA-matched donors after reduced-intensity conditioning. © 2023 British Society for Haematology and John Wiley & Sons Ltd. |
| Keywords: | adult; retrospective studies; transplantation, homologous; major clinical study; mortality; area under the curve; heart disease; lung disease; incidence; cohort analysis; recurrence; hematopoietic stem cell transplantation; retrospective study; age; disease severity; hla matching; donor; tissue donors; comorbidity; reduced intensity conditioning; transplantation conditioning; recurrent disease; allogeneic hematopoietic stem cell transplantation; gender; allotransplantation; receiver operating characteristic; procedures; non relapse mortality; humans; human; male; female; article; prognostic assessment; comorbidity assessment; non-relapse mortality; mild renal impairment; all cause mortality; allogeneic haematopoietic cell transplantation; simplified comorbidity index |
| Journal Title: | British Journal of Haematology |
| Volume: | 203 |
| Issue: | 5 |
| ISSN: | 0007-1048 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2023-12-01 |
| Start Page: | 840 |
| End Page: | 851 |
| Language: | English |
| DOI: | 10.1111/bjh.19055 |
| PUBMED: | 37614192 |
| PROVIDER: | scopus |
| PMCID: | PMC10843799 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Roni Shouval -- Source: Scopus |
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