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Pre-transplant comorbidity burden and post-transplant chronic graft-versus-host disease

Jennifer E Vaughn1,2, Ted Gooley3,4, Richard T Maziarz5,6

  • 1Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.

British Journal of Haematology
|July 22, 2015
PubMed

Insights

The Haematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) does not predict chronic graft-versus-host disease (GVHD) development. However, higher HCT-CI scores predict increased non-relapse and overall mortality after chronic GVHD.

Area of Science:

  • Hematology
  • Oncology
  • Immunology

Background:

  • The Haematopoietic Cell Transplantation-Comorbidity Index (HCT-CI) predicts non-relapse mortality post-hematopoietic stem cell transplant (HCT).
  • Chronic graft-versus-host disease (GVHD) is a significant contributor to mortality after HCT.

Purpose of the Study:

  • To evaluate the HCT-CI's predictive capability for chronic GVHD development.
  • To assess the HCT-CI's association with mortality following chronic GVHD.

Main Methods:

  • Retrospective analysis of 2909 patients undergoing allogeneic HCT.
  • Cox regression models adjusted for confounders to assess HCT-CI's predictive value.

Main Results:

  • HCT-CI was not significantly associated with chronic GVHD development (HR=1.02, P=0.34).
  • Increasing HCT-CI scores significantly predicted increased non-relapse mortality (HR=1.29, P<0.0001) and overall mortality (HR=1.25, P<0.001) post-chronic GVHD.
  • Associations were consistent across donor types and stem cell sources.

Conclusions:

  • The HCT-CI is not a reliable predictor for chronic GVHD development.
  • The HCT-CI effectively predicts mortality risk in patients who develop chronic GVHD.
  • HCT-CI scores may be valuable for designing clinical trials targeting chronic GVHD treatment.

Keywords:
Haematopoietic Cell Transplantation-Comorbidity Indexgraft-versus-host diseasehaematopoietic stem cellsnon-relapse mortality after HCTtransplantation

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