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Differential prognostic impact of pretransplant comorbidity on transplant outcomes by disease status and time from transplant: a single Japanese transplant centre study
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Differential prognostic impact of pretransplant comorbidity on transplant outcomes by disease status and time from transplant: a single Japanese transplant centre study
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Journal Article
Differential prognostic impact of pretransplant comorbidity on transplant outcomes by disease status and time from transplant: a single Japanese transplant centre study
2010
Overview
This retrospective study examined the differences in the prognostic impact of the haematopoietic cell transplantation-specific comorbidity index (HCT-CI) on transplant outcomes by disease status and time from transplant in allogeneic haematopoietic stem cell transplantation (HSCT) recipients at a Japanese transplant centre. Of 187 patients, nonrelapse mortality (NRM) at 3 years was 9.6, 21.2 and 27.8% in the low-risk (score 0), intermediate-risk (score 1–2) and high-risk (score ⩾3) HCT-CI groups, respectively (
P
=0.03). The corresponding overall survival (OS) at 3 years was 70.1, 60.5 and 38.9%, respectively (
P
<0.01). In multivariate analyses, high-risk HCT-CI significantly predicted higher NRM (relative risk, (RR) 2.44 (95% confidence interval, (CI) 1.02–5.85);
P
=0.04) and worse OS (RR 2.02 (95% CI 1.15–3.54);
P
=0.01). In the subgroup analysis according to disease status, the HCT-CI was associated with OS (
P
<0.01) and NRM (
P
=0.07) in patients with low-risk diseases, but not in those with high-risk diseases. Within patients who survived without relapse >1 year after HSCT, the HCT-CI did not predict OS (
P
=0.59) or NRM (
P
=0.31). These findings can be useful to determine the role of pretransplant comorbidity in allogeneic HSCT.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Adult
/ Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
/ Biological and medical sciences
/ Bone marrow, stem cells transplantation. Graft versus host reaction
/ Disease
/ Female
/ Hematologic Neoplasms - mortality
/ Hematologic Neoplasms - therapy
/ Hematopoietic Stem Cell Transplantation
/ Humans
/ Leukemia
/ Male
/ Medicine
/ Transfusions. Complications. Transfusion reactions. Cell and gene therapy
