title: Pretransplant comorbidities maintain their impact on allogeneic stem cell transplantation outcome 5 years posttransplant: a retrospective study in a single german institution.
abstract: The introduction of reduced-intensity conditioning regimens has allowed elderly patients with preexisting comorbidities access to the potentially curative allogeneic stem cell transplantation. Patient's comorbidities at the time of treatment consideration play a significant role in transplant outcome in terms of both overall survival (OS) and nonrelapse mortality (NRM). The hematopoietic stem cell transplantation comorbidity index (HCT-CI) quantifies these patient specific risks and has established itself as a major tool in the pretransplant assessment of patients. Many single center and multicenter studies have assessed the HCT-CI score and reported conflicting outcomes. The present study aimed to evaluate the HCT-CI in a single large European transplant centre. 245 patients were retrospectively analyzed and the predictive value of the score was assessed with respect to OS and NRM. We confirm that the HCT-CI predicts outcome for both OS and NRM. Moreover, we identified age of the patient as an independent prognostic parameter for OS. Incorporation of age in the HCT-CI would improve its ability to prognosticate and allow the transplant physician to assess the patient specific risks appropriately at the time of counseling for transplant.
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Jens M
authors.initials: JM
authors.lastname: Chemnitz
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Geothy
authors.identifier: 0000-0002-7706-8447
authors.initials: G
authors.lastname: Chakupurakal
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Maya
authors.initials: M
authors.lastname: Bäßler
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Udo
authors.initials: U
authors.lastname: Holtick
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Sebastian
authors.identifier: 0000-0001-5706-8258
authors.initials: S
authors.lastname: Theurich
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Shimabukuro-Vornhagen
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Leitzke
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Von Bergwelt-Baildon
authors.affiliation: BMT Program, Department I of Internal Medicine, University Hospital Cologne, Kerpener Straße 62, 50924 Köln, Germany.
authors.forename: Christof
authors.initials: C
authors.lastname: Scheid
references.citation: Bone Marrow Transplant. 2003 Nov;32(9):853-61
references.pmid: 14561984
references.citation: Leukemia. 2009 Jun;23(6):1131-8
references.pmid: 19194465
references.citation: Crit Rev Oncol Hematol. 2000 Sep;35(3):181-200
references.pmid: 10960800
references.citation: Blood. 2005 Oct 15;106(8):2912-9
references.pmid: 15994282
references.citation: Blood. 2013 Apr 11;121(15):2854-63
references.pmid: 23355537
references.citation: Bone Marrow Transplant. 2009 Jan;43(2):133-9
references.pmid: 18762762
references.citation: JAMA. 2011 Nov 2;306(17):1874-83
references.pmid: 22045765
references.citation: Br J Haematol. 2000 Oct;111(1):18-29
references.pmid: 11091179
references.citation: Biol Blood Marrow Transplant. 2008 Sep;14(9):985-992
references.pmid: 18721761
references.citation: J Cancer Res Clin Oncol. 2007 Dec;133(12):945-50
references.pmid: 17534661
references.citation: J Clin Epidemiol. 1994 Nov;47(11):1245-51
references.pmid: 7722560
references.citation: Blood. 2011 Mar 3;117(9):2728-34
references.pmid: 21228326
references.citation: Blood. 1998 Feb 1;91(3):756-63
references.pmid: 9446633
references.citation: Bone Marrow Transplant. 2011 Oct;46(10):1326-30
references.pmid: 21132027
references.citation: Eur J Cancer. 2000 Mar;36(4):453-71
references.pmid: 10717521
references.citation: J Clin Oncol. 2010 Jan 20;28(3):405-11
references.pmid: 20008642
references.citation: J Clin Oncol. 2007 Sep 20;25(27):4246-54
references.pmid: 17724349
references.citation: Leukemia. 1997 Mar;11(3):416-9
references.pmid: 9067582
references.citation: N Engl J Med. 1975 Apr 24;292(17):895-902
references.pmid: 235092
references.citation: J Chronic Dis. 1987;40(5):373-83
references.pmid: 3558716
references.citation: Biol Blood Marrow Transplant. 2011 Dec;17(12):1822-32
references.pmid: 21708108
references.citation: J Clin Oncol. 2010 Apr 10;28(11):1878-87
references.pmid: 20212255
references.citation: Bone Marrow Transplant. 2011 Jul;46(7):1000-5
references.pmid: 20921945
references.citation: Bone Marrow Transplant. 2004 Mar;33(5):477-82
references.pmid: 14730333