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Pre‐transplant comorbidity burden and post‐transplant chronic graft‐versus‐host disease
Author(s) -
Vaughn Jennifer E.,
Gooley Ted,
Maziarz Richard T.,
Pulsipher Michael A.,
Bhatia Smita,
Maloney David G.,
Sandmaier Brenda M.,
Flowers Mary E.,
Storb Rainer,
Sorror Mohamed L.
Publication year - 2015
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.13591
Subject(s) - medicine , graft versus host disease , hazard ratio , comorbidity , proportional hazards model , confounding , transplantation , hematopoietic stem cell transplantation , disease , immunology , oncology , gastroenterology , confidence interval
Summary The Haematopoietic Cell Transplantation‐Comorbidity Index ( HCT ‐ CI ) was designed as a predictor of non‐relapse mortality after HCT . Chronic graft‐versus‐host disease ( GVHD ) contributes to mortality after HCT . Here, we investigated whether the HCT ‐ CI could predict development of chronic GVHD or post‐chronic GVHD mortality. We retrospectively analysed data from 2909 patients treated with allogeneic HCT for malignant and non‐malignant haematological conditions at four institutions. In Cox regression models adjusted for potential confounders, increasing HCT ‐ CI was not statistically significantly associated with the development of chronic GVHD [hazard ratio (HR) = 1·02, P = 0·34]. Yet, the index was associated with an increased risk of non‐relapse mortality (HR = 1·29, P < 0·0001) as well as overall mortality (HR = 1·25, P < 0·001) following the development of chronic GVHD . The association between HCT ‐ CI and post‐chronic GVHD mortality was similar regardless of donor type or stem cell source. HCT ‐ CI scores could be incorporated in the design of clinical trials for treatment of chronic GVHD .