title: Validation of the Hematopoietic Cell Transplantation-Specific Comorbidity Index in a retrospective cohort of children and adolescents who received an allogeneic transplantation in Argentina.
abstract: Hematopoietic cell transplantationis a therapy with a risk of transplant-related mortality (TRM), which may vary depending on prior comorbidities. The Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) is an instrument developed to measure this risk. There are very few reports on its use in pediatrics. The objective of this study was to validate the HCT-CI in a pediatric cohort of allogeneic hematopoietic-cell transplantation recipients in Argentina.
  
  
  
  Retrospective cohort made up of 140 transplant patients a, Hospital J. P. Garrahan between 2008 and 2012. Medical records were reviewed to identify patient history and course. The HCT-CI was estimated for each patient, who was classified as having a low (score: 0), intermediate (score: 1-2) or high (score: >3) risk. Survival was estimated for each group using the Kaplan-Meier method and compared with the log-rank test. For malignancies, relapse was considered an event consistent with TRM. A p value 〈 0.05 was considered significant.
  
  
  
  The median score in the HCT-CI was 1 (r: 0-6). A score of 0 was observed in 45.7% of patients, 1-2 in 40.7%, and >3 in 13.6%. The most common comorbidities included obesity, infection, pulmonary and liver involvement. TRM was 14.1% among patients with a score of 0; 43.7% with a score of 1-2, and 52.6% with a score >3. Differences were observed among the survival curves of the three groups (p = 0.01).
  
  
  
  The HCT-CI demonstrated to be an effective tool to predict the risk of TRM in our setting.
  
  
  
  comorbidity, hematopoietic stem cell transplantation, non-relapse mortality, pediatrics.
authors.affiliation: Servicio de Trasplante de Médula Ósea, Hospital Garrahan, Ciudad Autónoma de Buenos Aires, Argentina. cfigueroa59@yahoo.com.ar.
authors.forename: Carlos M
authors.initials: CM
authors.lastname: Figueroa Turienzo
authors.affiliation: Coordinación de Investigación, Hospital Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Carolina
authors.initials: C
authors.lastname: Cernadas
authors.affiliation: Servicio de Trasplante de Médula Ósea, Hospital Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Mariana
authors.initials: M
authors.lastname: Roizen
authors.affiliation: Servicio de Trasplante de Médula Ósea, Hospital Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pizzi
authors.affiliation: Servicio de Trasplante de Médula Ósea, Hospital Garrahan, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: Raquel
authors.initials: R
authors.lastname: Staciuk
mesh_terms: D000293:Adolescent; D001118:Argentina; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D014184:Transplantation, Homologous
keywords: Comorbidity; Hematopoietic stem cell transplantation; Non-relapse mortality; Pediatrics