Prognostic implications of hematopoietic cell transplantation-specific comorbidity index on non-relapse mortality and overall survival after allogeneic hematopoietic stem cell transplantation / 中华血液学杂志

ABSTRACT

<p><b>OBJECTIVE</b>To study the prognostic implications of hematopoietic cell transplantation-specific comorbidity index (HCT-CI) on non-relapse mortality (NRM) and overall survival (OS) in patients underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT).</p><p><b>METHODS</b>Clinical data of 161 cases received allo-HSCT from July 2003 to November 2010 were analyzed retrospectively. The prognostic significance of HCT-CI, age, sex, conditioning regimens, disease status before transplantation, graft source and the degree of HLA matches for NRM and OS was conducted by COX regression model. The prognostic impact of HCT-CI on NRM and OS was performed in all patients under different disease status before transplantation.</p><p><b>RESULTS</b>Of the 161 cases with allo-HSCT, 3-year NRM and OS were 26.4% and 61.4% respectively. NRM at 3 years in patients with HCT-CI score 0, 1-2 and ≥3 were 14.9%, 24.5% and 52.7% respectively. And OS at 3 years were 68.9%, 64.6% and 34.7% respectively. There were significant differences between HCT-CI score 0 and ≥3 groups for NRM and OS (P<0.01). High-risk disease status before transplantation (NRM RR=3.35, P<0.01;OS RR=3.53, P<0.01) and HCT-CI score≥3 (NRM RR=6.85, P<0.01;OS RR=3.77, P<0.01)were independent risk factors by COX regression model. In the subgroup analysis according to disease status, high score of HCT-CI was associated with poor OS (P<0.01) and high NRM (P<0.01) in patients with low-risk, but not in those with high-risk disease status.</p><p><b>CONCLUSION</b>HCT-CI score and disease status before transplantation are independent risk factors for patients received allo-HSCT. HCT-CI score have prognostic implication for NRM and OS in patients with low-risk disease status, but not in high-risk group.</p>