Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8429740 | Biology of Blood and Marrow Transplantation | 2018 | 38 Pages |
Abstract
The hematopoietic cell transplantation-specific comorbidity index (HCT-CI) has been recently proposed to predict the probability of nonrelapse mortality (NRM) and overall survival (OS) in allogeneic hematopoietic stem cell transplantation (HSCT). However, the usefulness of the HCT-CI in single-unit umbilical cord blood transplantation (UCBT) remains unclear. We investigated the impact of the HCT-CI on the clinical outcomes of allogeneic HSCT in a single-center retrospective study including 53 recipients of UCBT (UCBT group) and 90 recipients of other HSCT (non-UCBT group). In the non-UCBT group 2-year OS rates for HCT-CI score <â3 andââ¥3 were 67% (nâ=â74; 95% confidence interval [CI], 54% to 78%) and 26% (nâ=â16; 95% CI, 7% to 51%), respectively (Pâ=â.001). In the UCBT group these rates were 66% (nâ=â39; 95% CI, 48% to 79%) and 69% (nâ=â14; 95% CI, 36% to 87%), respectively (Pâ=â.73). In the non-UCBT group 1-year NRM rates for HCT-CI score <â3 andââ¥3 were 14% (95% CI, 6.4% to 22%) and 37% (95% CI, 14% to 61%), respectively (Pâ=â.02). In the UCBT group these rates were 6.1% (95% CI, 3.4% to 24%) and 7.7% (95% CI, .4% to 29%), respectively (Pâ=â.78). Using multivariate analysis we showed that HCT-CI score ⥠3 was significantly associated with lower OS (hazard ratio, 3.06; 95% CI, 1.47 to 6.38; Pâ=â.003) and higher NRM (hazard ratio, 2.87; 95% CI, 1.18 to 6.96; Pâ=â.02) for the non-UCBT group. UCBT showed good OS with low incidence of NRM, even in patients with high HCT-CI scores. Altogether, we propose single-unit UCB to be a promising stem cell source for improving survival in patients with multiple comorbidities.
Related Topics
Life Sciences
Biochemistry, Genetics and Molecular Biology
Cancer Research
Authors
Yoshitaka Adachi, Shun Ukai, Ken Sagou, Nobuaki Fukushima, Kazutaka Ozeki, Akio Kohno,