The predictive value of HCT-CI and CCI comorbidity indices in predicting survival and mortality before allogeneic stem cell transplantation in acute leukemia patients: A single-centre experience

Objective: Acute leukemia often involves comorbidities, impacting treatment decisions and patient outcomes. Clinicians commonly use the Charlson Comorbidity Index (CCI) and the Hematopoietic Stem Cell Transplantation Comorbidity Index (HCT-CI) to assess their influence. However, their effectiveness in predicting survival and non-relapse mortality (NRM) in acute leukemia patients under 65 undergoing allogeneic stem cell transplantation remains unclear. Patients and Methods: We conducted a retrospective single-center analysis on adults diagnosed with acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL). The study included 35 patients, comprising 16 AML and 19 ALL cases. Patients were categorized based on age-adjusted HCT-CI and CCI scores. Results: The 2-year NRM rate was determined to be 51.4%. Statistical analysis found no significant associations between age-adjusted CCI (p=0.217) and age-adjusted HCT-CI (p=0.102) with NRM. However, median overall survival significantly varied based on risk levels (p=0.003), HCT-CI groups (p=0.009), and CCI groups (p=0.011). Conclusion: Using age-adjusted HCT-CI and CCI for comorbidity scoring in initial assessment of acute leukemia patients and those under 65 shows promise. However, these indices were ineffective in predicting NRM, emphasizing the importance of considering other significant pre-transplant factors like genetic risk, conditioning regimens, and donor type.