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Impact of comorbidities constituting the HCT-CI score on the outcome of patients undergoing allogeneic HCT for AML.

Research paper by Manar M I MMI Khalil, Jeffrey H JH Lipton, Eshetu G EG Atenafu, Vikas V Gupta, Dennis D DD Kim, John J Kuruvilla, Auro A Viswabandya, Hans A HA Messner, Fotios V FV Michelis

Indexed on: 24 Nov '17Published on: 24 Nov '17Published in: European Journal of Haematology



Abstract

To investigate the prognostic impact of the individual component comorbidities of the hematopoietic cell transplant co-morbidity index (HCT-CI) in patients with acute myeloid leukemia (AML) that underwent allogeneic hematopoietic cell transplant (HCT).This single-center study retrospectively investigated the individual comorbidities of the HCT-CI on the outcome of 418 patients that underwent HCT for AML, in CR1 (n=303, 72%) or CR2 (n=115, 28%) at our center between 1999 and 2014.Median age at HCT was 50 years (range 18-71). Univariate analysis of the HCT-CI, grouped as score 0 (n=109), 1-2 (n=157) and ≥3 (n=152), demonstrated significant influence on OS (p=0.004) and NRM (p=0.02). For individual comorbidities constituting the HCT-CI, variables with a p-value ≤0.2 on univariate analysis were included in the multivariable analysis. For OS, none of the comorbidities of the HCT-CI demonstrated independent prognostic relevance. However, for NRM, multivariable analysis demonstrated that pre-transplant diabetes (HR=2.17, 95%CI=1.31-3.60, p=0.003) and cardiovascular comorbidity (HR=1.78, 95%CI=1.15-2.76, p=0.01) to be independent predictors of NRM post-transplant.Among the comorbidities that compose the HCT-CI, diabetes and cardiovascular comorbidity independently predict NRM in patients undergoing allogeneic HCT for AML. This information should be taken into consideration regarding post-transplant monitoring and care. This article is protected by copyright. All rights reserved.

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