title: Multi-centre validation of the prognostic value of the haematopoietic cell transplantation- specific comorbidity index among recipient of allogeneic haematopoietic cell transplantation.
abstract: The haematopoietic cell transplantation-specific comorbidity index (HCT-CI) was developed in a single centre as a weighted scoring system to predict risks of non-relapse mortality (NRM) following allogeneic haematopoietic cell transplantation. Information on the performance of the HCT-CI in multi-centre studies is lacking in the literature. To that end, a collaborative multicentre retrospective study was initiated. Comorbidity data from 2523 consecutive recipients of human leucocyte antigen-matched grafts from five different US institutions were analysed. Among all patients, HCT-CI scores of 0 vs. 1-2 vs. ≥3 were associated with 2-year NRM rates of 14%, 23% and 39% (P < 0·0001), respectively, and 2-year overall survival (OS) rates of 74%, 61% and 39%, respectively (P < 0·0001). Using regression models, increasing HCT-CI scores were independently associated with increases in hazard ratios for NRM and worse survival within individual institutions. The HCT-CI retained independent capacity for association with outcomes within different age as well as conditioning intensity groups. C-statistic estimates for the prognostic power of the HCT-CI for NRM and OS were 0·66 and 0·64, respectively. The estimates within each institution were overall similar. The HCT-CI is a valid tool for capturing comorbidities and predicting mortality after haematopoietic cell transplantation across different institutions.
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|National Cancer Institute, Cairo University, Cairo, Egypt.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: ElSawy
authors.affiliation: Clinical Statistics Program, Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Biostatistics, University of Washington School of Public Health, Seattle, WA, USA.
authors.forename: Barry E
authors.initials: BE
authors.lastname: Storer
authors.affiliation: Division of Hematology/Blood and Marrow Transplantation, University of Utah School of Medicine, Logan, UT, USA.|Pediatric Blood and Marrow Transplant Program, Primary Children's Medical Center, Huntsman Cancer Institute, Salt Lake City, UT, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.affiliation: Center for Hematologic Malignancies, OHSU Knight Cancer Institute, Portland, OR, USA.|Division of Hematology and Medical Oncology, Oregon Health & Science University School of Medicine, Portland, OR, USA.
authors.forename: Richard T
authors.initials: RT
authors.lastname: Maziarz
authors.affiliation: Department of Population Sciences, Center for Cancer Survivorship, City of Hope School of Medicine, Duarte, CA, USA.
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
authors.affiliation: Colorado Blood Cancer Institute School of Medicine, Denver, CO, USA.
authors.forename: Michael B
authors.initials: MB
authors.lastname: Maris
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine Seattle, Seattle, WA, USA.
authors.forename: Karen L
authors.initials: KL
authors.lastname: Syrjala
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Martin
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: David G
authors.initials: DG
authors.lastname: Maloney
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Brenda M
authors.initials: BM
authors.lastname: Sandmaier
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Rainer
authors.initials: R
authors.lastname: Storb
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.|Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA.
authors.forename: Mohamed L
authors.initials: ML
authors.lastname: Sorror
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D012189:Retrospective Studies; D015996:Survival Rate
keywords: HCT-CI; allogeneic; comorbidities; haematopoietic cell transplantation; validation