Combination of the Hematopoietic Cell Transplantation Comorbidity Index and the European Group for Blood and Marrow Transplantation Score Allows a Better Stratification of High-Risk Patients Undergoing Reduced-Toxicity Allogeneic Hematopoietic Cell Transplantation
Barba, Pere (Hospital Universitari Vall d'Hebron)
Martino Bofarull, Rodrigo (Institut d'Investigació Biomèdica Sant Pau)
Pérez-Simón, José Antonio (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Fernandez Aviles, Francesc (Hospital Clínic i Provincial de Barcelona)
Castillo Flores, Nerea (Hospital Universitari Vall d'Hebron)
Piñana, José Luis (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
López-Anglada, Lucía (Hospital Universitario de Salamanca)
Rovira Argelagués, Montserrat (Hospital Clínic i Provincial de Barcelona)
Bosch Albareda, Francesc 1947- (Hospital Universitari Vall d'Hebron)
Carreras, Enric (Hospital Clínic i Provincial de Barcelona)
López Corral, Lucía (Hospital Universitario de Salamanca)
Sierra, Jorge (Institut d'Investigació Biomèdica Sant Pau)
Valcárcel, David (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2014
Abstract:	This study was conducted to determine whether the integration of the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) and the European Group for Blood and Marrow Transplantation (EBMT) score would improve individual capacity for stratification of high-risk HCT candidates. A total of 442 consecutive patients receiving an allogeneic HCT after reduced-toxicity conditioning was included. Final HCT-CI and EBMT scores were calculated and validated. Then, patients were grouped into a 6-category new combination model according to the HCT-CI (0, 1 to 2, ≥3) and EBMT scores (0 to 3, 4 to 7), and the model's predictive capacity was also evaluated. Median HCT-CI and EBMT scores were 3 and 4, respectively. Increased HCT-CI was associated with higher 4-year nonrelapse mortality (NRM) and lower 4-year overall survival (OS), whereas a high EBMT score was associated with higher 4-year NRM. The HCT-CI showed a trend for a better predictive capacity than the EBMT score (c-statistic. 6 versus. 54, P=1). According to the new model, patients within HCT-CI of 0 and HCT-CI of 1 to 2 groups had similar risk of NRM independently of their EBMT score. Within the HCT-CI ≥ 3 group, patients with low EBMT score showed lower NRM (25% versus 40%, P=04) and a trend to higher OS (52% versus 36%, P=06) than patients with a high EBMT score. Moreover, patients with HCT-CI ≥ 3 and EBMT score 0 to 3 had similar outcomes than those with HCT-CI of 1 to 2. In conclusion, the combination of HCT-CI and the EBMT score is feasible and might contribute to a better identification of high-risk patients, improving selection of best allogeneic HCT candidates. © 2014 American Society for Blood and Marrow Transplantation.
Grants:	Ministerio de Ciencia e Innovación PI1100872 Ministerio de Economía y Competitividad RD12/0036/0071 Fundació la Marató de TV3 100830/31/32
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Allo-reduced-intensity conditioning ; Comorbidity ; EBMT score ; HCT-CI ; Reduced-intensity conditioning stem cell transplantation
Published in:	Biology of blood and marrow transplantation, Vol. 20 Núm. 1 (january 2014) , p. 66-72, ISSN 1523-6536

DOI: 10.1016/j.bbmt.2013.10.011
PMID: 24141006

7 p, 320.9 KB

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