Hematopoietic Cell Transplantation Comorbidity Index Predicts Outcomes in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Receiving CD34+ Selected Grafts for Allogeneic Hematopoietic Cell Transplantation

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

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12 Citations (Scopus)

Abstract

© 2017 The American Society for Blood and Marrow Transplantation 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.
Original languageEnglish
Pages (from-to)67-74
JournalBiology of Blood and Marrow Transplantation
Volume23
Issue number1
DOIs
Publication statusPublished - 1 Jan 2017

Keywords

  • Allogeneic hematopoietic cell transplantation
  • Comorbidity
  • HCT-CI
  • T cell depletion

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    Barba, P., Ratan, R., Cho, C., Ceberio, I., Hilden, P., Devlin, S. M., Maloy, M. A., Barker, J. N., Castro-Malaspina, H., Jakubowski, A. A., Koehne, G., Papadopoulos, E. B., Ponce, D. M., Sauter, C., Tamari, R., van den Brink, M. R. M., Young, J. W., O'Reilly, R. J., Giralt, S. A., & Perales, M. A. (2017). Hematopoietic Cell Transplantation Comorbidity Index Predicts Outcomes in Patients with Acute Myeloid Leukemia and Myelodysplastic Syndromes Receiving CD34+ Selected Grafts for Allogeneic Hematopoietic Cell Transplantation. Biology of Blood and Marrow Transplantation, 23(1), 67-74. https://doi.org/10.1016/j.bbmt.2016.10.017