Hematopoietic Cell Transplant Specific Comorbidity Index, Disease Status at Transplant and Graft Source as Risk Factors in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplant - Abstract
Allogeneic hematopoietic stem cell transplant is an important modality of treatment for patients bearing malignant and benign hematologic diseases, representing a chance of cure. As every treatment, it has a treatment-related mortality influenced by comorbidities. Our objective was to apply the Hematopoietic Cell Transplant Specific Comorbidity Index (HCT-CI) and to find risk factors for Non-Relapse Mortality (NRM) and Overall Survival (OS) in patients who underwent an allogeneic hematopoietic stemcell transplant in our institution, between 1993 and 2010. Medical charts from 457
patients were reviewed. Most patients (59.2%) received score 0, followed by 29.6% of cases with score 1-2 and 11.2% score 3-7. In a univariate analysis, comorbidity score (0 vs. ?1) had a NRM of 33% vs. 45% (p=0.01) and OS at 5 years of 53% vs. 35% (p=0.001); Disease status at Transplant (low vs. high risk disease) had a NRM of 30% vs. 50% (p<0.0001) and OS of 57% vs. 27% (p<0.0001); graft source (bone marrow vs. peripheral blood) had a NRM of 29% vs. 49% (p<0.0001) and OS 56%
vs. 34% (p<0.0001). The multivariate analysis confirmed the influence of HCT-CI score on NRM and OS, Disease Status at Transplant on OS and Graft Source on NRM.. When stratified by comorbidity (0 and ?1), Disease Status at Transplant and Graft Source influenced NRM and OS in both univariate and multivariate analysis. We were able to validate the HCT-CI in our institution, and the score is used now to guide the treatment strategy of patients with comorbidities.