Development of the Renal Adjusted Hematopoietic Cell Transplant Comorbidity Index (RA-HCT-CI) Using Different Levels of Renal Dysfunction According to Estimated Glomerular Filtration Rate (eGFR)

Abstract

Background Chronic kidney disease (CKD) is a known risk factor for post-HCT mortality. Currently, HCT-CI assigns a score of 2 for moderate-severe renal dysfunction based on serum creatinine (Cr), though Cr is not ideal marker of renal function and can be influenced by several factors. The aim of this study is to examine whether utilization of incremental degrees of renal dysfunction based on eGFR improves the utility of HCT-CI to predict allogeneic HCT outcomes. Method Patients age ≥40 years receiving HCT for malignancies from 2008 to 2016 were included. Estimated glomerular filtration rate (eGFR), calculated using CKD-epidemiology collaboration method, was used to categorize patients into 4 groups: eGFR ≥ 90ml/min (n=7062), eGFR 60-90 (n=5264), eGFR 45-59 (n=897) and eGFR Results eGFR groups were similar on disease risk index, graft and donor source, but patients with eGFR≥90 were younger and received a myeloablative regimen more frequently. Patients with eGFR Conclusion These findings provide support that degree of renal dysfunction is independent predictor of OS and TRM after allogeneic HCT. In addition, the newly developed RA-HCT-CI is valid in predicting both TRM and OS and performs similarly to original HCT-CI.