The Hematopoietic Cell Transplantation-Specific Comorbidity Index Fails to Predict Outcomes in High-Risk AML Patients Undergoing Allogeneic Transplantation-Investigation of Potential Limitations of the Index
The Hematopoietic Cell Transplantation-Specific Comorbidity Index Fails to Predict Outcomes in High-Risk AML Patients Undergoing Allogeneic Transplantation-Investigation of Potential Limitations of the Index
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DOI：
10.1016/j.bbmt.2011.06.009
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发表时间：
2011-12-01
影响因子：
4.3
通讯作者：
Schetelig, Johannes
中科院分区：
文献类型：
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作者：
Birninger, Nicole;Bornhaeuser, Martin;Schetelig, Johannes
在异基因造血细胞移植(allo-HSCT)的背景下，共病是一个重要的危险因素。在华盛顿州西雅图开发并验证的造血细胞移植特异性共病指数(HSCT-CI)被用来预测allo-HSCT后的无复发死亡率(NRM)和总存活率(OS)。我们进行了一项单中心的回顾性研究，以验证在2000年1月至2008年12月期间接受allo-HSCT的高危急性髓系白血病患者中，HSCT-CI对移植结果的预后影响。移植时患者的平均年龄为53岁(范围：11-76岁)。移植前HSCT-CI评分中位数为4(范围0~10)。在340例患者中，低危、中危和高危HSCT-CI组3年OS分别为29%(95%可信区间：7%-41%)、40%(33%-47%)和44%(41%-47%)(P=0.7)。3年NRM分别为34%(10%~58%)、32%(20%~44%)和26%(20%~32%；P=0.6)。在多变量分析中，我们发现HSU-CI对OS或NRM都没有预测价值。在交叉验证研究明确表明HSCT-CI的有效性之前，不应考虑将HSCT-CI作为移植资格的决策工具。生物骨髓移植17：1822-1832(2011)(C)2011年美国血液和骨髓移植学会
In the context of allogeneic hematopoietic cell transplantation (allo-HSCT), comorbidities are an important risk factor. Use of the hematopoietic cell transplantation-specific comorbidity index (HSCT-CI), which was developed and validated in Seattle, Washington, has been proposed to predict the probability of nonrelapse mortality (NRM) and overall survival (OS) following allo-HSCT. We performed a single-center retrospective study to validate the prognostic impact of HSCT-CI on transplant outcomes in a cohort of high-risk acute myeloid leukemia patients undergoing allo-HSCT between January 2000 and December 2008. The median patient age at the time of transplantation was 53 years (range: 11-76 years). The median pretransplantation HSCT-CI score was 4 (range: 0-10). Among 340 patients, OS at 3 years was 29% (95% confidence interval [Cl]: I 7%-41%), 40% (33%-47%), and 44% (41%-47%) in the low-, intermediate-, and high-risk HSCT-CI groups (P =.7), respectively. The corresponding NRM at 3 years was 34% (10%-58%), 32% (20%-44%), and 26% (20%-32%; P =.6). In multivariate analysis, we found no predictive value of HSU-CI for either OS or NRM. The use of HSCT-CI as a decision-making tool for transplantation eligibility should not be considered until its validity has been unequivocally shown in crossvalidation studies. Biol Blood Marrow Transplant 17: 1822-1832 (2011) (C) 2011 American Society for Blood and Marrow Transplantation