scholarly journals Validation of the Hematopoietic Cell Transplantation- Specific Comorbidity Index in a retrospective cohort of children and adolescents who received an allogeneic transplantation in Argentina

2016 ◽  
Vol 114 (04) ◽  
Keyword(s):  
Children And Adolescents ◽  
Cell Transplantation ◽  
Retrospective Cohort ◽  
Hematopoietic Cell Transplantation ◽  
Allogeneic Transplantation ◽  
Hematopoietic Cell ◽  
Comorbidity Index

scholarly journals ROLE OF COMORBIDITIES IN OPTIMIZING DECISION-MAKING FOR ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANTATION

2010 ◽  
Vol 2 (2) ◽  
pp. e2010015 ◽  
Author(s):  
Mohamed L. Sorror ◽  
Rainer F. Storb
Keyword(s):  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Medical Condition ◽  
Laboratory Data ◽  
Young Patients ◽  
Allogeneic Transplantation ◽  
Hematopoietic Cell ◽  
High Dose ◽  
Conditioning Regimens ◽  
Comorbidity Index

Allogeneic conventional hematopoietic cell transplantation (HCT) following high-dose, myeloablative conditioning regimens has been used since the 1970’s as potentially curative treatment for patients with malignant, hematological disorders. The toxicities of conditioning regimens have limited conventional HCT to relatively young patients in otherwise good medical condition. With the development of less toxic nonmyeloablative regimens and improvements in supportive care, increasing numbers of older and medically infirm patients have been treated by allogeneic HCT. Until recently, there has been almost no effort to evaluate the prevalence of comorbidities among HCT recipients and their impact on outcomes. We first evaluated the Charlson Comorbidity Index (CCI) developed for patients with solid malignancies, for this purpose. While useful, it lacked sensitivity and specificity for the HCT setting. We next introduced the HCT-specific comorbidity index (HCT-CI) which was based on objective laboratory data to better define comorbidities. Here, we describe this development and illustrate the usefulness of the HCT-CI in predicting HCT outcomes in patients with myeloid and lymphoid malignancies undergoing allogeneic transplantation 

Impact of Palifermin on Transplant Outcomes in Children and Adolescents Undergoing Allogeneic Hematopoietic Cell Transplantation

2020 ◽  
Vol 40 (11) ◽  
pp. 6531-6537
Author(s):  
KRZYSZTOF CZYŻEWSKI ◽  
ROBERT DĘBSKI ◽  
NATALIA BARTOSZEWICZ ◽  
EWA DEMIDOWICZ ◽  
MONIKA RICHERT-PRZYGOŃSKA ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Hematopoietic Cell ◽  
Allogeneic Hematopoietic Cell Transplantation ◽  
Transplant Outcomes

scholarly journals Hematopoietic cell transplantation–specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences

Blood ◽  
2007 ◽  
Vol 110 (13) ◽  
pp. 4606-4613 ◽  
Author(s):  
Mohamed L. Sorror ◽  
Sergio Giralt ◽  
Brenda M. Sandmaier ◽  
Marcos De Lima ◽  
Munir Shahjahan ◽  
...  
Keyword(s):  
Acute Myeloid Leukemia ◽  
Cell Transplantation ◽  
Myeloid Leukemia ◽  
Hematopoietic Cell Transplantation ◽  
Survival Rates ◽  
Hematologic Malignancies ◽  
Hematopoietic Cell ◽  
Cancer Center ◽  
Comorbidity Index ◽  
Acute Myeloid

A new hematopoietic cell transplantation–specific comorbidity index (HCT-CI) was effective in predicting outcomes among patients with hematologic malignancies who underwent HCT at Fred Hutchinson Cancer Research Center (FHCRC). Here, we compared the performance of the HCT-CI to 2 other indices and then tested its capacity to predict outcomes among 2 cohorts of patients diagnosed with a single disease entity, acute myeloid leukemia in first complete remission, who underwent transplantation at either FHCRC or M. D. Anderson Cancer Center (MDACC). FHCRC patients less frequently had unfavorable cytogenetics (15% versus 36%) and HCT-CI scores of 3 or more (21% versus 58%) compared with MDACC patients. We found that the HCT-CI had higher sensitivity and outcome predictability compared with the other indices among both cohorts. HCT-CI scores of 0, 1 to 2, and 3 or more predicted comparable nonrelapse mortality (NRM) among FHCRC and MDACC patients. In multivariate models, HCT-CI scores were associated with the highest hazard ratios (HRS) for NRM and survival among each cohort. The 2-year survival rates among FHCRC and MDACC patients were 71% versus 56%, respectively. After adjustment for risk factors, including HCT-CI scores, no difference in survival was detected (HR: 0.98, P = .94). The HCT-CI is a sensitive and informative tool for comparing trial results at different institutions. Inclusion of comorbidity data in HCT trials provides valuable, independent information.

Hematopoietic cell transplantation comorbidity index predicts transplantation outcomes in pediatric patients

Blood ◽  
2011 ◽  
Vol 117 (9) ◽  
pp. 2728-2734 ◽  
Author(s):  
Angela R. Smith ◽  
Navneet S. Majhail ◽  
Margaret L. MacMillan ◽  
Todd E. DeFor ◽  
Sonata Jodele ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Cell Transplantation ◽  
Pediatric Patients ◽  
Hematopoietic Cell Transplantation ◽  
Risk Groups ◽  
Hematopoietic Cell ◽  
Relative Risks ◽  
Innovative Therapies ◽  
Comorbidity Index

Abstract Quantifying the risk of hematopoietic cell transplantation (HCT)–related mortality for pediatric patients is challenging. The HCT-specific comorbidity index (HCT-CI) has been confirmed as a useful tool in adults, but has not yet been validated in children. We conducted a retrospective cohort study of 252 pediatric patients undergoing their first allogeneic HCT between January 2008 and May 2009. Pretransplantation comorbidities were scored prospectively using the HCT-CI. Median age at transplantation was 6 years (range, 0.1-20) and median follow-up was 343 days (range, 110-624). HCT-CI scores were distributed as follows: 0, n = 139; 1-2, n = 52; and 3+, n = 61. The 1-year cumulative incidence of nonrelapse mortality (NRM) increased (10%, 14%, and 28%, respectively; P < .01) and overall survival (OS) decreased (88%, 67%, and 62%, respectively; P < .01) with increasing HCT-CI score. Multivariate analysis showed that compared with score 0, those with scores of 1-2 and 3+ had relative risks of NRM of 1.5 (95% confidence interval, 0.5-4.3, P = .48) and 4.5 (95% confidence interval, 1.7-12.1, P < .01), respectively. These results indicate that the HCT-CI score predicts NRM and OS in pediatric patients undergoing HCT and is a useful tool to assess risk, guide counseling in the pretransplantation setting, and devise innovative therapies for the highest risk groups.

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