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

JE Vaughn, T Gooley, RT Maziarz… - British journal of …, 2015 - Wiley Online Library
JE Vaughn, T Gooley, RT Maziarz, MA Pulsipher, S Bhatia, DG Maloney, BM Sandmaier
British journal of haematology, 2015Wiley Online Library
Summary The Haematopoietic Cell Transplantation‐Comorbidity Index (HCT‐CI) was
designed as a predictor of non‐relapse mortality after HCT. Chronic graft‐versus‐host
disease (GVHD) contributes to mortality after HCT. Here, we investigated whether the HCT‐
CI could predict development of chronic GVHD or post‐chronic GVHD mortality. We
retrospectively analysed data from 2909 patients treated with allogeneic HCT for malignant
and non‐malignant haematological conditions at four institutions. In Cox regression models …
Summary
The Haematopoietic Cell Transplantation‐Comorbidity Index (HCT‐CI) was designed as a predictor of non‐relapse mortality after HCT. Chronic graft‐versus‐host disease (GVHD) contributes to mortality after HCT. Here, we investigated whether the HCT‐CI could predict development of chronic GVHD or post‐chronic GVHD mortality. We retrospectively analysed data from 2909 patients treated with allogeneic HCT for malignant and non‐malignant haematological conditions at four institutions. In Cox regression models adjusted for potential confounders, increasing HCT‐CI was not statistically significantly associated with the development of chronic GVHD [hazard ratio (HR) = 1·02, = 0·34]. Yet, the index was associated with an increased risk of non‐relapse mortality (HR = 1·29, < 0·0001) as well as overall mortality (HR = 1·25, < 0·001) following the development of chronic GVHD. The association between HCT‐CI and post‐chronic GVHD mortality was similar regardless of donor type or stem cell source. HCT‐CI scores could be incorporated in the design of clinical trials for treatment of chronic GVHD.
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