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PMID: 15994282 Published · ppublish English Journal Article Research Support, N.I.H., Extramural Research Support, U.S. Gov't, P.H.S.

Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT.

Blood ·Vol. 106 ·No. 8 ·2005-10-15 ·Pages 2912-9

Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, Storer B

Abstract

We previously reported that the Charlson Comorbidity Index (CCI) was useful for predicting outcomes in patients undergoing allogeneic hematopoietic cell transplantation (HCT). However, the sample size of patients with scores of 1 or more, captured by the CCI, did not exceed 35%. Further, some comorbidities were rarely found among patients who underwent HCT. Therefore, the current study was designed to (1) better define previously identified comorbidities using pretransplant laboratory data, (2) investigate additional HCT-related comorbidities, and (3) establish comorbidity scores that were suited for HCT. Data were collected from 1055 patients, and then randomly divided into training and validation sets. Weights were assigned to individual comorbidities according to their prognostic significance in Cox proportional hazard models. The new index was then validated. The new index proved to be more sensitive than the CCI since it captured 62% of patients with scores more than 0 compared with 12%, respectively. Further, the new index showed better survival prediction than the CCI (likelihood ratio of 23.7 versus 7.1 and c statistics of 0.661 versus 0.561, respectively, P < .001). In conclusion, the new simple index provided valid and reliable scoring of pretransplant comorbidities that predicted nonrelapse mortality and survival. This index will be useful for clinical trials and patient counseling before HCT.

MeSH Terms
Adolescent Adult Aged Cause of Death Child Child, Preschool Comorbidity Contraindications Female Humans Infant Male Middle Aged Prognosis Proportional Hazards Models Reproducibility of Results Risk Assessment Stem Cell Transplantation Survival Rate Transplantation, Homologous Treatment Outcome
Authors & Affiliations
7 authors, click to expand affiliations / ORCID
Sorror Mohamed L
Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, D1-100, PO Box 19024, Seattle, WA 98109-1024, USA.
Maris Michael B
Storb Rainer
Baron Frederic
Sandmaier Brenda M
Maloney David G
Storer Barry
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Article Info
Journal
Blood
Abbr.
Blood
ISSN
0006-4971
DOI
10.1182/blood-2005-05-2004
Published
2005-10-15
Epub
2005-00-30
Pages
2912-9
Language
English
Region
United States
NLM ID
7603509
PMCID
PMC1895304
Subset
IM
Grants
NCI NIH HHS · CA18029 · United States
NHLBI NIH HHS · HL36444 · United States
NCI NIH HHS · CA78902 · United States
NCI NIH HHS · CA92058 · United States
NCI NIH HHS · CA49605 · United States
NCI NIH HHS · CA15704 · United States
NCI NIH HHS · P01 CA078902 · United States
External Links
PubMed source DOI: 10.1182/blood-2005-05-2004 PMC Full Text View journal details
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