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Post-Transplant Events

Performance status, but not the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI), predicts mortality at a Canadian transplant center

Bone Marrow Transplantation volume 43, pages 133–139 (2009)Cite this article

Abstract

The hematopoietic cell transplantation-specific comorbidity index (HCT-CI) was developed at a single center to predict outcomes for allogeneic transplant recipients who have comorbidities. The HCT-CI has not been widely validated in unselected transplant recipients. We evaluated whether the HCT-CI and other readily available pre-transplant variables predicted NRM and OS at a Canadian transplant center. Using a prospective cohort design, we analyzed consecutive adult allogeneic HCT recipients. Of 187 patients, HCT-CI risk was low in 22 (12%), intermediate in 50 (27%), high in 104 (55%) and undetermined in 11 (6%). Two-year OS was 45% (95% CI: 24–64%), 55% (95% CI: 40–68%) and 42% (95% CI: 32–51%) in the low, intermediate and high-risk HCT-CI groups, respectively. Two-year NRM was 36% (95% CI: 17–56%), 26% (95% CI: 15–39%) and 30% (95% CI: 22–39%) in the low, intermediate and high-risk HCT-CI groups, respectively. In multivariate analysis, the HCT-CI failed to predict OS or NRM. However, KPS of <90% at HCT was a strong predictor of NRM. In conclusion, the HCT-CI was not associated with NRM or OS. In contrast, KPS was an independent indicator of survival. International multi-center studies are required before the HCT-CI is used in clinical practice.

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Acknowledgements

We are grateful to the Leukemia Lymphoma Society of Canada for financially supporting this project. We thank the nursing staff at Winnipeg Health Sciences Centre and CancerCare Manitoba for their excellent patient care.

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Authors and Affiliations

  1. Manitoba Blood and Marrow Transplant Program, Winnipeg, Manitoba, Canada

    R Guilfoyle, A Demers, E Richardson, M Rubinger, D Szwajcer & M D Seftel

  2. Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

    R Guilfoyle, M Rubinger, D Szwajcer & M D Seftel

  3. CancerCare Manitoba, Winnipeg, Manitoba, Canada

    A Demers, E Richardson, M Rubinger, D Szwajcer & M D Seftel

  4. Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA

    C Bredeson

Authors
  1. R Guilfoyle
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Correspondence to M D Seftel.

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Guilfoyle, R., Demers, A., Bredeson, C. et al. Performance status, but not the Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI), predicts mortality at a Canadian transplant center. Bone Marrow Transplant 43, 133–139 (2009). https://doi.org/10.1038/bmt.2008.300

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