JGO-00219; No. of pages: 7; 4C: J O U RN A L OF GE RI A T RI C O NC O L O G Y XX ( 20 1 4 ) XX X–XX X
Available online at www.sciencedirect.com
ScienceDirect
Hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of adverse events and overall survival in older allogeneic transplant recipients Jesse W. Keller1 , Charalambos Andreadis, Lloyd E. Damon, Lawrence D. Kaplan, Thomas G. Martin, Jeffrey L. Wolf, Weiyun Z. Ai, Jeffrey M. Venstrom, Catherine C. Smith, Karin M.L. Gaensler, Jimmy Hwang, Rebecca L. Olin⁎ Adult Blood and Marrow Transplant Program, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143, USA
AR TIC LE I N FO
ABS TR ACT
Article history:
Objectives: Our goal was to evaluate the ability of the hematopoietic cell transplantation
Received 13 September 2013
comorbidity index (HCT-CI) to predict outcomes after allogeneic stem cell transplant (SCT)
Received in revised form
within the context of an older patient population, where multiple comorbidities are
3 February 2014
common.
Accepted 24 April 2014
Materials and methods: We performed a retrospective cohort study of SCT patients ≥50 years of age at our institution, identifying 59 patients with complete HCT-CI data collected prospectively.
Keywords:
Results: HCT-CI category distribution in our sample was disproportionate, with almost half
Hematopoietic stem
of patients having scores ≥ 3. High HCT-CI score (≥ 3 vs 65 years of age. Ann Oncol Jun 2008;19(6): 1166–1171. Labonte L, Iqbal T, Zaidi MA, McDiarmid SA, Huebsch LB, Tay J, et al. Utility of comorbidity assessment in predicting transplantation-related toxicity following autologous hematopoietic stem cell transplantation for multiple myeloma. Biol Blood Marrow Transplant Sep 2008;14(9): 1039–1044. Sperr WR, Wimazal F, Kundi M, Baumgartner C, Nosslinger T, Makrai A, et al. Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study Group. Ann Oncol Jan 2010;21(1):114–119. Giles FJ, Borthakur G, Ravandi F, Faderl S, Verstovsek S, Thomas D, et al. The haematopoietic cell transplantation comorbidity index score is predictive of early death and survival in patients over 60 years of age receiving induction therapy for acute myeloid leukaemia. Br J Haematol Feb 2007;136(4):624–627. Raimondi R, Tosetto A, Oneto R, Cavazzina R, Rodeghiero F, Bacigalupo A, et al. Validation of the hematopoietic cell transplantation-specific comorbidity index: a prospective, multicenter GITMO study. Blood Aug 9 2012;120(6): 1327–1333. El Kourashy S, Williamson T, Chaudhry MA, Savoie ML, Turner AR, Larratt L, et al. Influence of comorbidities on transplant outcomes in patients aged 50 years or more after myeloablative conditioning incorporating fludarabine, BU and ATG. Bone Marrow Transplant Aug 2011;46(8):1077–1083. Sorror ML, Sandmaier BM, Storer BE, Franke GN, Laport GG, Chauncey TR, et al. Long-term outcomes among older patients following nonmyeloablative conditioning and allogeneic hematopoietic cell transplantation for advanced hematologic malignancies. JAMA Nov 2 2011;306(17): 1874–1883. Castagna L, Fürst S, Marchetti N, El Cheikh J, Faucher C, Mohty M, Bouabdallah R, Vey N, Stoppa AM, Esterni B, Blaise D. Retrospective analysis of common scoring systems and outcome in patients older than 60 years treated with reduced-intensity conditioning regimen and alloSCT. Bone Marrow Transplant 2011;46(7):1000–1005, http://dx.doi.org/10.1038/bmt.2010.227 [Epub 2010 Oct 4, PMID: 20921945]. Majhail NS, Brunstein CG, Tomblyn M, Thomas AJ, Miller JS, Arora M, et al. Reduced-intensity allogeneic transplant in patients older than 55 years: unrelated umbilical cord blood is safe and effective for patients without a matched related donor. Biol Blood Marrow Transplant Mar 2008;14(3): 282–289. Takasaki H, Tanaka M, Tachibana T, Numata A, Fujimaki K, Sakai R, et al. Prognostic factors in patients aged 50 years or older undergoing allogeneic hematopoietic stem cell transplantation for hematologic malignancy. Int J Hematol Mar 2012;95(3):291–298. Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant Dec 2005;11(12): 945–956. Coffey DG, Pollyea DA, Myint H, Smith C, Gutman JA. Adjusting DLCO for Hb and its effects on the hematopoietic cell transplantation-specific comorbidity index. Bone Marrow
Please cite this article as: Keller JW., et al, Hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of adverse events and overall survival in older allogeneic..., J Geriatr Oncol (2014), http://dx.doi.org/10.1016/j.jgo.2014.04.003
J O U RN A L OF GE RI A T RI C O NC O L O G Y XX ( 20 1 4 ) XX X–XX X
Transplant 2013;48(9):1253–1256, http://dx.doi.org/ 10.1038/bmt.2013.31 [Epub 2013 Mar 18, PMID: 23503530]. 21. Sorror ML. How I, assess comorbidities before hematopoietic cell transplantation. Blood Apr 11 2013;121(15): 2854–2863.
7
22. Muffly LS, Boulukos M, Swanson K, Kocherginsky M, Cerro PD, Schroeder L, et al. Pilot study of comprehensive geriatric assessment (CGA) in allogeneic transplant: CGA captures a high prevalence of vulnerabilities in older transplant recipients. Biol Blood Marrow Transplant Mar 2013;19(3): 429–434.
Please cite this article as: Keller JW., et al, Hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of adverse events and overall survival in older allogeneic..., J Geriatr Oncol (2014), http://dx.doi.org/10.1016/j.jgo.2014.04.003
Available online at www.sciencedirect.com
ScienceDirect
Hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of adverse events and overall survival in older allogeneic transplant recipients Jesse W. Keller1 , Charalambos Andreadis, Lloyd E. Damon, Lawrence D. Kaplan, Thomas G. Martin, Jeffrey L. Wolf, Weiyun Z. Ai, Jeffrey M. Venstrom, Catherine C. Smith, Karin M.L. Gaensler, Jimmy Hwang, Rebecca L. Olin⁎ Adult Blood and Marrow Transplant Program, Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, 400 Parnassus Avenue, San Francisco, CA 94143, USA
AR TIC LE I N FO
ABS TR ACT
Article history:
Objectives: Our goal was to evaluate the ability of the hematopoietic cell transplantation
Received 13 September 2013
comorbidity index (HCT-CI) to predict outcomes after allogeneic stem cell transplant (SCT)
Received in revised form
within the context of an older patient population, where multiple comorbidities are
3 February 2014
common.
Accepted 24 April 2014
Materials and methods: We performed a retrospective cohort study of SCT patients ≥50 years of age at our institution, identifying 59 patients with complete HCT-CI data collected prospectively.
Keywords:
Results: HCT-CI category distribution in our sample was disproportionate, with almost half
Hematopoietic stem
of patients having scores ≥ 3. High HCT-CI score (≥ 3 vs 65 years of age. Ann Oncol Jun 2008;19(6): 1166–1171. Labonte L, Iqbal T, Zaidi MA, McDiarmid SA, Huebsch LB, Tay J, et al. Utility of comorbidity assessment in predicting transplantation-related toxicity following autologous hematopoietic stem cell transplantation for multiple myeloma. Biol Blood Marrow Transplant Sep 2008;14(9): 1039–1044. Sperr WR, Wimazal F, Kundi M, Baumgartner C, Nosslinger T, Makrai A, et al. Comorbidity as prognostic variable in MDS: comparative evaluation of the HCT-CI and CCI in a core dataset of 419 patients of the Austrian MDS Study Group. Ann Oncol Jan 2010;21(1):114–119. Giles FJ, Borthakur G, Ravandi F, Faderl S, Verstovsek S, Thomas D, et al. The haematopoietic cell transplantation comorbidity index score is predictive of early death and survival in patients over 60 years of age receiving induction therapy for acute myeloid leukaemia. Br J Haematol Feb 2007;136(4):624–627. Raimondi R, Tosetto A, Oneto R, Cavazzina R, Rodeghiero F, Bacigalupo A, et al. Validation of the hematopoietic cell transplantation-specific comorbidity index: a prospective, multicenter GITMO study. Blood Aug 9 2012;120(6): 1327–1333. El Kourashy S, Williamson T, Chaudhry MA, Savoie ML, Turner AR, Larratt L, et al. Influence of comorbidities on transplant outcomes in patients aged 50 years or more after myeloablative conditioning incorporating fludarabine, BU and ATG. Bone Marrow Transplant Aug 2011;46(8):1077–1083. Sorror ML, Sandmaier BM, Storer BE, Franke GN, Laport GG, Chauncey TR, et al. Long-term outcomes among older patients following nonmyeloablative conditioning and allogeneic hematopoietic cell transplantation for advanced hematologic malignancies. JAMA Nov 2 2011;306(17): 1874–1883. Castagna L, Fürst S, Marchetti N, El Cheikh J, Faucher C, Mohty M, Bouabdallah R, Vey N, Stoppa AM, Esterni B, Blaise D. Retrospective analysis of common scoring systems and outcome in patients older than 60 years treated with reduced-intensity conditioning regimen and alloSCT. Bone Marrow Transplant 2011;46(7):1000–1005, http://dx.doi.org/10.1038/bmt.2010.227 [Epub 2010 Oct 4, PMID: 20921945]. Majhail NS, Brunstein CG, Tomblyn M, Thomas AJ, Miller JS, Arora M, et al. Reduced-intensity allogeneic transplant in patients older than 55 years: unrelated umbilical cord blood is safe and effective for patients without a matched related donor. Biol Blood Marrow Transplant Mar 2008;14(3): 282–289. Takasaki H, Tanaka M, Tachibana T, Numata A, Fujimaki K, Sakai R, et al. Prognostic factors in patients aged 50 years or older undergoing allogeneic hematopoietic stem cell transplantation for hematologic malignancy. Int J Hematol Mar 2012;95(3):291–298. Filipovich AH, Weisdorf D, Pavletic S, Socie G, Wingard JR, Lee SJ, et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. Diagnosis and staging working group report. Biol Blood Marrow Transplant Dec 2005;11(12): 945–956. Coffey DG, Pollyea DA, Myint H, Smith C, Gutman JA. Adjusting DLCO for Hb and its effects on the hematopoietic cell transplantation-specific comorbidity index. Bone Marrow
Please cite this article as: Keller JW., et al, Hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of adverse events and overall survival in older allogeneic..., J Geriatr Oncol (2014), http://dx.doi.org/10.1016/j.jgo.2014.04.003
J O U RN A L OF GE RI A T RI C O NC O L O G Y XX ( 20 1 4 ) XX X–XX X
Transplant 2013;48(9):1253–1256, http://dx.doi.org/ 10.1038/bmt.2013.31 [Epub 2013 Mar 18, PMID: 23503530]. 21. Sorror ML. How I, assess comorbidities before hematopoietic cell transplantation. Blood Apr 11 2013;121(15): 2854–2863.
7
22. Muffly LS, Boulukos M, Swanson K, Kocherginsky M, Cerro PD, Schroeder L, et al. Pilot study of comprehensive geriatric assessment (CGA) in allogeneic transplant: CGA captures a high prevalence of vulnerabilities in older transplant recipients. Biol Blood Marrow Transplant Mar 2013;19(3): 429–434.
Please cite this article as: Keller JW., et al, Hematopoietic cell transplantation comorbidity index (HCT-CI) is predictive of adverse events and overall survival in older allogeneic..., J Geriatr Oncol (2014), http://dx.doi.org/10.1016/j.jgo.2014.04.003
