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Impact of comorbidities constituting the hematopoietic cell transplant (HCT)‐comorbidity index on the outcome of patients undergoing allogeneic HCT for acute myeloid leukemia
Author(s) -
Khalil Manar M. I.,
Lipton Jeffrey H.,
Atenafu Eshetu G.,
Gupta Vikas,
Kim Dennis D.,
Kuruvilla John,
Viswabandya Auro,
Messner Hans A.,
Michelis Fotios V.
Publication year - 2018
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13000
Subject(s) - myeloid leukemia , hematopoietic cell , medicine , comorbidity , oncology , hematopoietic stem cell transplantation , myeloid , haematopoiesis , transplantation , stem cell , biology , genetics
Objective To investigate the prognostic impact of the individual component comorbidities of the hematopoietic cell transplant comorbidity index ( HCT ‐ CI ) in patients with acute myeloid leukemia ( AML ) that underwent allogeneic hematopoietic cell transplant ( HCT ). Method 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 CR 1 (n = 303, 72%) or CR 2 (n = 115, 28%) at our center between 1999 and 2014. Results 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 overall survival ( OS ) ( P = .004) and non‐relapse mortality ( NRM ) ( P = .02). For individual comorbidities constituting the HCT ‐ CI , variables with a P ‐value ≤ .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 pretransplant diabetes ( HR = 2.17, 95% CI = 1.31‐3.60, P = .003) and cardiovascular comorbidity ( HR = 1.78, 95% CI = 1.15‐2.76, P = .01) to be independent predictors of NRM post‐transplant. Conclusion 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.