Literature DB >> 29168234

Impact of comorbidities constituting the hematopoietic cell transplant (HCT)-comorbidity index on the outcome of patients undergoing allogeneic HCT for acute myeloid leukemia.

Manar M I Khalil1, Jeffrey H Lipton1, Eshetu G Atenafu2, Vikas Gupta1, Dennis D Kim1, John Kuruvilla1, Auro Viswabandya1, Hans A Messner1, Fotios V Michelis1.   

Abstract

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 CR1 (n = 303, 72%) or CR2 (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.
© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Entities:  

Keywords:  acute myeloid leukemia; allogeneic hematopoietic cell transplant; comorbidity; hematopoietic cell transplant comorbidity index

Mesh:

Year:  2017        PMID: 29168234     DOI: 10.1111/ejh.13000

Source DB:  PubMed          Journal:  Eur J Haematol        ISSN: 0902-4441            Impact factor:   2.997


  5 in total

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