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10.1182/blood-2014-01-550566

http://scihub22266oqcxt.onion/10.1182/blood-2014-01-550566
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suck abstract from ncbi


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pmid24797298
      Blood 2014 ; 124 (2 ): 287-95
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  • Pretransplant comorbidities predict severity of acute graft-versus-host disease and subsequent mortality #MMPMID24797298
  • Sorror ML ; Martin PJ ; Storb RF ; Bhatia S ; Maziarz RT ; Pulsipher MA ; Maris MB ; Davis C ; Deeg HJ ; Lee SJ ; Maloney DG ; Sandmaier BM ; Appelbaum FR ; Gooley TA
  • Blood 2014[Jul]; 124 (2 ): 287-95 PMID24797298 show ga
  • Whether the hematopoietic cell transplantation comorbidity index (HCT-CI) can provide prognostic information about development of acute graft-versus-host disease (GVHD) and subsequent mortality is unknown. Five institutions contributed information on 2985 patients given human leukocyte antigen-matched grafts to address this question. Proportional hazards models were used to estimate the hazards of acute GVHD and post-GVHD mortality after adjustment for known risk variables. Higher HCT-CI scores predicted increased risk of grades 3 to 4 acute GVHD (P < .0001 and c-statistic of 0.64), and tests of interaction suggested that this association was consistent among different conditioning intensities, donor types, and stem cell sources. Probabilities of grades 3 to 4 GVHD were 13%, 18%, and 24% for HCT-CI risk groups of 0, 1 to 4, and ?5. The HCT-CI was statistically significantly associated with mortality rates following diagnosis of grade 2 (hazard ratio [HR] = 1.24; P < .0001) or grades 3 to 4 acute GVHD (HR = 1.19; P < .0001). Patients with HCT-CI scores of ?3 who developed grades 3 to 4 acute GVHD had a 2.63-fold higher risk of mortality than those with scores of 0 to 2 and did not develop acute GVHD. Thus, pretransplant comorbidities are associated with the development and severity of acute GVHD and with post-GVHD mortality. The HCT-CI could be useful in designing trials for GVHD prevention and could inform expectations for GVHD treatment trials.
  • |*Hematopoietic Stem Cell Transplantation/adverse effects/statistics & numerical data [MESH]
  • |Adolescent [MESH]
  • |Adult [MESH]
  • |Aged [MESH]
  • |Child [MESH]
  • |Child, Preschool [MESH]
  • |Comorbidity [MESH]
  • |Graft vs Host Disease/*diagnosis/etiology/*mortality [MESH]
  • |Hematologic Diseases/*diagnosis/*mortality/*therapy [MESH]
  • |Humans [MESH]
  • |Infant [MESH]
  • |Infant, Newborn [MESH]
  • |Middle Aged [MESH]
  • |Prognosis [MESH]
  • |Retrospective Studies [MESH]
  • |Transplantation Conditioning/adverse effects/methods/mortality [MESH]


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