The hematopoietic cell transplantation comorbidity index (HCT-CI) predicts clinical outcomes in lymphoma and myeloma patients after reduced-intensity or non-myeloablative allogeneic stem cell transplantation

The hematopoietic cell transplantation specific comorbidity index (HCT-CI) has been developed to identify patients at high risk of mortality after an allograft. Reduced-intensity/non-myeloablative regimens have decreased the non-relapse mortality (NRM) in elderly and/or heavily pretreated patients. We performed a retrospective study to assess whether HCT-CI may predict clinical outcomes in a cohort of 203 patients with non-Hodgkin's (NHL; n= 108), Hodgkin's lymphomas (HL; n= 26), and multiple myeloma (MM; n= 69), who were transplanted from a human leucocyte antigen (HLA)-matched sibling ( n= 121) or an unrelated donor ( n= 82) after a reduced-intensity regimen ( n= 154) or a low-dose total body irradiation-based non-myeloblative regimen ( n= 49). Cumulative incidence of NRM was 5, 16 and 20% at 1 year and 6, 24 and 27% at 2 years, for patients with an HCT-CI of 0, 1–2 and ⩾3, respectively. By multivariate analysis, HCT-CI significantly predicted NRM (hazard ratio (HR)=1.6, P= 0.03), overall survival (OS; HR=1.62, P