Abstract
<h3>Introduction</h3> One-year survival outcomes for allogeneic hematopoietic cell transplants (HCT) at an Academic Medical Center's Blood and Marrow Transplant (BMT) program fell outside the risk-adjusted outcomes model developed by the Center for International Blood & Marrow Transplant Research (CIBMTR)[1]. Suitability Review was designed in order to evaluate potential allogeneic HCT recipients deemed high-risk based on CIBMTR survival statistics. <h3>Methods</h3> Center-specific results were used in order to recognize variables identified as clinically significant for allogeneic HCT patients in relation to one-year survival outcomes[1]. Recipients were presented for formal discussion in Suitability Review with the following criteria: • Relapsed/refractory lymphoma, regardless of age • Co-morbidity index (CI) (Sorror Score) >/= 8, regardless of age • Age >/= 65, regardless of CI or diagnosis • Significant clinical decline, disease progression, or prolonged hospitalization within 21 days of HCT preparative regimen Predicted patient one-year survival probability estimate was calculated using the CIBMTR survival calculator tool[2]. Cases were presented to Academic Medical Center's BMT Medical Director and transplant provider team by patient's primary transplant physician. Potential recipients were deemed eligible, ineligible or deferred. The review process was documented in the center's electronic transplant database. <h3>Results</h3> One-year survival for high-risk HCT patients that proceeded to transplant after suitability review was 58%. Expected survivals for this patient populated would be less than 35% based on CIBMTR survival statistics. <h3>Conclusion</h3> Allogeneic HCT remains a potential curative treatment option for high-risk HCT patients. Suitability Review continues to be modified to reflect advances in treatment options while still providing exceptional care to complicated patients with advanced disease and significant co-morbidities.
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