TY - JOUR
T1 - The Simplified Comorbidity Index predicts non-relapse mortality in reduced-intensity conditioning allogeneic haematopoietic cell transplantation
AU - Elias, Shlomo
AU - Brown, Samantha
AU - Devlin, Sean M.
AU - Barker, Juliet N.
AU - Cho, Christina
AU - Chung, David J.
AU - Dahi, Parastoo B.
AU - Giralt, Sergio
AU - Gyurkocza, Boglarka
AU - Jakubowski, Ann A.
AU - Lahoud, Oscar B.
AU - Landau, Heather
AU - Lin, Richard J.
AU - Papadopoulos, Esperanza B.
AU - Politikos, Ioannis
AU - Ponce, Doris M.
AU - Scordo, Michael
AU - Shaffer, Brian C.
AU - Shah, Gunjan L.
AU - Tamari, Roni
AU - Young, James W.
AU - Perales, Miguel Angel
AU - Shouval, Roni
N1 - Publisher Copyright:
© 2023 British Society for Haematology and John Wiley & Sons Ltd.
PY - 2023/12
Y1 - 2023/12
N2 - Comorbidity assessment before allogeneic haematopoietic cell transplantation (allo-HCT) is essential for estimating non-relapse mortality (NRM) risk. We previously developed the Simplified Comorbidity Index (SCI), which captures a small number of ‘high-yield’ comorbidities and older age. The SCI was predictive of NRM in myeloablative CD34-selected allo-HCT. Here, we evaluated the SCI in a single-centre cohort of 327 patients receiving reduced-intensity conditioning followed by unmanipulated allografts from HLA-matched donors. Among the SCI factors, age above 60, mild renal impairment, moderate pulmonary disease and cardiac disease were most frequent. SCI scores ranged from 0 to 8, with 39%, 20%, 20% and 21% having scores of 0–1, 2, 3 and ≥4 respectively. Corresponding cumulative incidences of 3-year NRM were 11%, 16%, 22% and 27%; p = 0.03. In multivariable models, higher SCI scores were associated with incremental risks of all-cause mortality and NRM. The SCI had an area under the receiver operating characteristic curve of 65.9%, 64.1% and 62.9% for predicting 1-, 2- and 3-year NRM versus 58.4%, 60.4% and 59.3% with the haematopoietic cell transplantation comorbidity index. These results demonstrate for the first time that the SCI is predictive of NRM in patients receiving allo-HCT from HLA-matched donors after reduced-intensity conditioning.
AB - Comorbidity assessment before allogeneic haematopoietic cell transplantation (allo-HCT) is essential for estimating non-relapse mortality (NRM) risk. We previously developed the Simplified Comorbidity Index (SCI), which captures a small number of ‘high-yield’ comorbidities and older age. The SCI was predictive of NRM in myeloablative CD34-selected allo-HCT. Here, we evaluated the SCI in a single-centre cohort of 327 patients receiving reduced-intensity conditioning followed by unmanipulated allografts from HLA-matched donors. Among the SCI factors, age above 60, mild renal impairment, moderate pulmonary disease and cardiac disease were most frequent. SCI scores ranged from 0 to 8, with 39%, 20%, 20% and 21% having scores of 0–1, 2, 3 and ≥4 respectively. Corresponding cumulative incidences of 3-year NRM were 11%, 16%, 22% and 27%; p = 0.03. In multivariable models, higher SCI scores were associated with incremental risks of all-cause mortality and NRM. The SCI had an area under the receiver operating characteristic curve of 65.9%, 64.1% and 62.9% for predicting 1-, 2- and 3-year NRM versus 58.4%, 60.4% and 59.3% with the haematopoietic cell transplantation comorbidity index. These results demonstrate for the first time that the SCI is predictive of NRM in patients receiving allo-HCT from HLA-matched donors after reduced-intensity conditioning.
KW - Simplified Comorbidity Index
KW - allogeneic haematopoietic cell transplantation
KW - comorbidity
KW - non-relapse mortality
UR - http://www.scopus.com/inward/record.url?scp=85168617963&partnerID=8YFLogxK
U2 - 10.1111/bjh.19055
DO - 10.1111/bjh.19055
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C2 - 37614192
AN - SCOPUS:85168617963
SN - 0007-1048
VL - 203
SP - 840
EP - 851
JO - British Journal of Haematology
JF - British Journal of Haematology
IS - 5
ER -