title: Assessing the Influence of Different Comorbidities Indexes on the Outcomes of Allogeneic Hematopoietic Stem Cell Transplantation in a Developing Country.
abstract: Although the application of Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) has enabled better prediction of transplant-related mortality (TRM) in allogeneic hematopoietic stem cell transplants (AHSCT), data from developing countries are scarce. This study prospectively evaluated the HCT-CI and the Adult Comorbidity Evaluation (ACE-27), in its original and in a modified version, as predictors of post-transplant complications in adults undergoing a first related or unrelated AHSCT in Brazil. Both bone marrow (BM) and peripheral blood stem cells (PBSC) as graft sources were included. We analyzed the cumulative incidence of granulocyte and platelet recovery, sinusoidal obstructive syndrome, acute and chronic graft-versus-host disease, relapse and transplant-related mortality, and rates of event-free survival and overall survival. Ninety-nine patients were assessed. Median age was 38 years (18-65 years); HCT-CI ≥ 3 accounted for only 8% of cases; hematologic malignancies comprised 75.8% of the indications for AHSCT. There was no association between the HCT-CI or the original or modified ACE-27 with TRM or any other studied outcomes after AHSCT. These results show that, in the population studied, none of the comorbidity indexes seem to be associated with AHSCT outcomes. A significantly low frequency of high-risk (HCT-CI ≥ 3) in this Brazilian population might justify these results.
authors.affiliation: Post Graduation Program Adult Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Gustavo Machado
authors.initials: GM
authors.lastname: Teixeira
authors.affiliation: Hematology-Oncology Division, CHU Sainte-Justine, University of Montreal, Montreal, Canada; Department of Pediatrics, School of Medicine, University of Montreal, Montreal, Canada.
authors.forename: Henrique
authors.initials: H
authors.lastname: Bittencourt
authors.affiliation: Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Antonio Vaz
authors.initials: AV
authors.lastname: de Macedo
authors.affiliation: Hospital das Clinicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Glaucia Helena
authors.initials: GH
authors.lastname: Martinho
authors.affiliation: Institute of Exact Sciences, Department of Statistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Enrico Antônio
authors.initials: EA
authors.lastname: Colosimo
authors.affiliation: Post Graduation Program Adult Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Internal Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Suely Meireles
authors.initials: SM
authors.lastname: Rezende
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001854:Bone Marrow Cells / Q000166:cytology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D001938:Brazil; D015331:Cohort Studies; D015897:Comorbidity; D003906:Developing Countries; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology* / Q000401:mortality; D019337:Hematologic Neoplasms / Q000209:etiology / Q000401:mortality; D006410:Hematopoiesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012008:Recurrence; D015996:Survival Rate; D014184:Transplantation, Homologous; D055815:Young Adult