Abstract
The introduction of reduced-intensity conditioning regimens has allowed elderly patients with preexisting comorbidities access to the potentially curative allogeneic stem cell transplantation. Patient's comorbidities at the time of treatment consideration play a significant role in transplant outcome in terms of both overall survival (OS) and nonrelapse mortality (NRM). The hematopoietic stem cell transplantation comorbidity index (HCT-CI) quantifies these patient specific risks and has established itself as a major tool in the pretransplant assessment of patients. Many single center and multicenter studies have assessed the HCT-CI score and reported conflicting outcomes. The present study aimed to evaluate the HCT-CI in a single large European transplant centre. 245 patients were retrospectively analyzed and the predictive value of the score was assessed with respect to OS and NRM. We confirm that the HCT-CI predicts outcome for both OS and NRM. Moreover, we identified age of the patient as an independent prognostic parameter for OS. Incorporation of age in the HCT-CI would improve its ability to prognosticate and allow the transplant physician to assess the patient specific risks appropriately at the time of counseling for transplant.
Highlights
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapeutic option for a variety of haematological malignancies [1]
The present study aimed to evaluate the hematopoietic stem cell transplantation comorbidity index (HCT-CI) in a single large European transplant centre. 245 patients were retrospectively analyzed and the predictive value of the score was assessed with respect to overall survival (OS) and nonrelapse mortality (NRM)
Increase in the average age of the cancer patients has led to a concerted effort in developing scoring systems which help in predicting outcomes following treatment [17]
Summary
Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative therapeutic option for a variety of haematological malignancies [1]. Lack of inclusion of significant comorbidities like preexisting infections and stringent pretransplant exclusion criteria meant that in the HSCT setting CCI had very low sensitivity to identify the patients at a higher risk of a TRM. This leads to the development of hematopoietic cell transplantationcomorbidity index (HCT-CI) [7]. Retrospective reviews performed in various institutions gave conflicting reports [8,9,10,11,12,13,14] This retrospective study aims to assess the ability of HCT-CI to predict outcome with respect to OS and NRM in a large German single center transplant unit, University of Cologne, Germany
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