Internal Medicine, Hematology and BMT unit
Contributions
Type: Publication Only
Background
Background Heamtopoeitic Stem cell transplantation (HSCT) is a procedure that can restore marrow function for patients who have had severe marrow injury, replacement of marrow by disease, or abnormalities of the immune system..It is either autologous or allogenic.
It has become increasingly important to optimize pre-transplant risk assessment in order to improve HCT decision making and clinical trial assignments.
Single-organ comorbidity involving liver, lung, heart, or kidney before HCT has been traditionally found to cause organ toxicity after HCT.
The HCT-comorbidity index (HCT-CI) has provided better prediction of HCT-related morbidity and mortality than other non-HCT-specific indices
Aims
The aim of this work is to study the impact of various pretransplant comorbidities on outcome of patients who had undergone either-allogenic or autologous HSCT -in relation to treatment related mortality and disease related mortaliy with specific emphasis on overall survival
Methods
A retrospective study was conducted at the bone marrow Transplantation Unit, of internal medicine department Ain Shams University on 119 patients who were transplanted either by autologous or allogenic HSCT (matched or mismatched related donor).
All of them were aged >18ys.and had different types of hematologic diseases; the most frequent being AML(34.4%) followed by multiple myeloma(17.6%) then ALL(16.8%) and lymphoma (10.9%) whereas,aplastic anemia,MDS,CML and biphenotypic leukemia.collectively were20.1%.They were either in complete or partial remission according to the type of disease.
They were categorized according to HCT-CI into mild score (0) 43 patients (36.2%), moderate score (1-2) 60 patients (50.4%) and severe score (≥3) 16 patients (13.4%)
The study data were collected from medical notes, pathology reports and laboratory data
Results
There was statistically significant relation between HCT-CI and overall survival (p 0.012), disease free survival (p 0.007), mortality(p 0.047 ). and the incidence of graft failure.(p 0.034 )
Comparison between different HCT-CI scores as regard overall survival (Kaplan- Maier curve): P<0.05S
Score | Median | SE | 95% Confidence Interval | Log Rank | P-value |
Mild | 67.85 | 8.18 | (51.82-83.88) | 8.790 | 0.012 S |
Moderate | 62.06 | 7.14 | (48.07-76.05) | ||
Severe | 5.00 | 2.66 | (0.00-10.21) |
Summary
In our study, we could conclude that the HCT-CI is a better predictor to detect the influence of comorbidity in patients with hematologic disorders on mortality, overall survival and disease free survival post HCT.
Keyword(s): Hematopoietic cell transplantation, Outcome
Session topic: Publication Only
Type: Publication Only
Background
Background Heamtopoeitic Stem cell transplantation (HSCT) is a procedure that can restore marrow function for patients who have had severe marrow injury, replacement of marrow by disease, or abnormalities of the immune system..It is either autologous or allogenic.
It has become increasingly important to optimize pre-transplant risk assessment in order to improve HCT decision making and clinical trial assignments.
Single-organ comorbidity involving liver, lung, heart, or kidney before HCT has been traditionally found to cause organ toxicity after HCT.
The HCT-comorbidity index (HCT-CI) has provided better prediction of HCT-related morbidity and mortality than other non-HCT-specific indices
Aims
The aim of this work is to study the impact of various pretransplant comorbidities on outcome of patients who had undergone either-allogenic or autologous HSCT -in relation to treatment related mortality and disease related mortaliy with specific emphasis on overall survival
Methods
A retrospective study was conducted at the bone marrow Transplantation Unit, of internal medicine department Ain Shams University on 119 patients who were transplanted either by autologous or allogenic HSCT (matched or mismatched related donor).
All of them were aged >18ys.and had different types of hematologic diseases; the most frequent being AML(34.4%) followed by multiple myeloma(17.6%) then ALL(16.8%) and lymphoma (10.9%) whereas,aplastic anemia,MDS,CML and biphenotypic leukemia.collectively were20.1%.They were either in complete or partial remission according to the type of disease.
They were categorized according to HCT-CI into mild score (0) 43 patients (36.2%), moderate score (1-2) 60 patients (50.4%) and severe score (≥3) 16 patients (13.4%)
The study data were collected from medical notes, pathology reports and laboratory data
Results
There was statistically significant relation between HCT-CI and overall survival (p 0.012), disease free survival (p 0.007), mortality(p 0.047 ). and the incidence of graft failure.(p 0.034 )
Comparison between different HCT-CI scores as regard overall survival (Kaplan- Maier curve): P<0.05S
Score | Median | SE | 95% Confidence Interval | Log Rank | P-value |
Mild | 67.85 | 8.18 | (51.82-83.88) | 8.790 | 0.012 S |
Moderate | 62.06 | 7.14 | (48.07-76.05) | ||
Severe | 5.00 | 2.66 | (0.00-10.21) |
Summary
In our study, we could conclude that the HCT-CI is a better predictor to detect the influence of comorbidity in patients with hematologic disorders on mortality, overall survival and disease free survival post HCT.
Keyword(s): Hematopoietic cell transplantation, Outcome
Session topic: Publication Only