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造血细胞移植特异性合并症指数(HCT-CI)是部分匹配相关供体移植的预后预测指标。

The hematopoietic cell transplantation-specific comorbidity index (HCT-CI) is an outcome predictor for partially matched related donor transplantation.

机构信息

Peking University People's Hospital & Institute of Hematology, Beijing Key laboratory of Hematopoietic Stem Cell Transplantation. No. 11 Xizhimen South Street, Xicheng District, Beijing, 100044, People's Republic of China.

出版信息

Am J Hematol. 2013 Jun;88(6):497-502. doi: 10.1002/ajh.23443. Epub 2013 May 8.

Abstract

To validate the predictive ability of the Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) on the outcome of hematopoietic stem cell transplantation (HSCT) patients who received transplants from partially matched related donors (PMRD), a total of 526 patients who received PMRD HSCT between January 2006 and December 2009 at the Institute of Hematology, Peking University were enrolled. Patients were grouped according to their HCT-CI score; 31.0%, 31.4%, and 37.6% of patients had HCT-CI scores of 0, 1-2, and ≥3, respectively. Patients with HCT-CI scores of ≥3 had a significantly poorer 2-year overall survival (OS) than patients with HCT-CI scores of 0-2 (54.55% vs. 78.05%, P < 0.001). In addition, patients with HCT-CI scores of ≥3 had a significantly higher 2-year cumulative incidence of relapse and nonrelapse mortality (NRM) than patients with scores of 0-2 (relapse: 23.23% vs. 11.59%, P < 0.001; NRM: 34.30% vs. 15.93%, P < 0.001). HCT-CI scores of <3 were associated with better OS, less relapse, and lower NRM in multivariate analysis. Patients who had high comorbidity scores as well as high-risk disease had the poorest outcomes. Therefore, we found that HCT-CI is associated with the outcomes of PMRD HSCT and we should closely monitor patients with a high comorbidity burden.

摘要

为了验证造血干细胞移植特异性合并症指数(HCT-CI)对接受部分匹配相关供者(PMRD)移植的造血干细胞移植(HSCT)患者结局的预测能力,共纳入了 526 例 2006 年 1 月至 2009 年 12 月在北京大学血液病研究所接受 PMRD HSCT 的患者。根据 HCT-CI 评分将患者分为三组;0、1-2 和≥3 组患者分别占 31.0%、31.4%和 37.6%。HCT-CI 评分≥3 的患者 2 年总生存(OS)明显差于 HCT-CI 评分 0-2 的患者(54.55% vs. 78.05%,P < 0.001)。此外,HCT-CI 评分≥3 的患者 2 年累积复发率和非复发死亡率(NRM)明显高于 HCT-CI 评分 0-2 的患者(复发:23.23% vs. 11.59%,P < 0.001;NRM:34.30% vs. 15.93%,P < 0.001)。多变量分析显示,HCT-CI<3 与 OS 改善、复发减少和 NRM 降低相关。高合并症评分和高危疾病的患者结局最差。因此,我们发现 HCT-CI 与 PMRD HSCT 的结局相关,我们应密切监测合并症负担高的患者。

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