Hematopoietic Cell Transplantation Comorbidity Index Predicts Outcomes in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Receiving CD34

Autor: Pere, Barba, Ravin, Ratan, Christina, Cho, Izaskun, Ceberio, Patrick, Hilden, Sean M, Devlin, Molly A, Maloy, Juliet N, Barker, Hugo, Castro-Malaspina, Ann A, Jakubowski, Guenther, Koehne, Esperanza B, Papadopoulos, Doris M, Ponce, Craig, Sauter, Roni, Tamari, Marcel R M, van den Brink, James W, Young, Richard J, O'Reilly, Sergio A, Giralt, Miguel-Angel, Perales
Rok vydání: 2016
Předmět:
Zdroj: Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 23(1)
ISSN: 1523-6536
Popis: 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.
Databáze: OpenAIRE