title: Pre-transplant comorbidity burden and post-transplant chronic graft-versus-host disease.
abstract: The Haematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) was designed as a predictor of non-relapse mortality after HCT. Chronic graft-versus-host disease (GVHD) contributes to mortality after HCT. Here, we investigated whether the HCT-CI could predict development of chronic GVHD or post-chronic GVHD mortality. We retrospectively analysed data from 2909 patients treated with allogeneic HCT for malignant and non-malignant haematological conditions at four institutions. In Cox regression models adjusted for potential confounders, increasing HCT-CI was not statistically significantly associated with the development of chronic GVHD [hazard ratio (HR) = 1·02, P = 0·34]. Yet, the index was associated with an increased risk of non-relapse mortality (HR = 1·29, P < 0·0001) as well as overall mortality (HR = 1·25, P < 0·001) following the development of chronic GVHD. The association between HCT-CI and post-chronic GVHD mortality was similar regardless of donor type or stem cell source. HCT-CI scores could be incorporated in the design of clinical trials for treatment of chronic GVHD.
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: Jennifer E
authors.initials: JE
authors.lastname: Vaughn
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: Ted
authors.initials: T
authors.lastname: Gooley
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: Division of Hematology and Hematological Malignancies, Huntsman Cancer Institute, University of Utah School of Medicine, Salt Lake City, UT, USA.|Pediatric Blood and Marrow Transplant Program, Primary Children's Hospital, Salt Lake City, UT, USA.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.affiliation: City of Hope School of Medicine, Duarte, CA, USA.
authors.forename: Smita
authors.initials: S
authors.lastname: Bhatia
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: Mary E
authors.initials: ME
authors.lastname: Flowers
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; D000368:Aged; D064591:Allografts; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality* / Q000473:pathology; D006402:Hematologic Diseases / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate; D014019:Tissue Donors
keywords: Haematopoietic Cell Transplantation-Comorbidity Index; graft-versus-host disease; haematopoietic stem cells; non-relapse mortality after HCT; transplantation