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Blood, 15 December 2007, Vol. 110, No. 13, pp. 4606-4613.
Prepublished online as a Blood First Edition Paper on September 14, 2007; DOI 10.1182/blood-2007-06-096966.
 Previous Article | Next Article 
Submitted June 21, 2007
Accepted August 21, 2007
Hematopoietic cell transplantation-specific comorbidity index as an outcome predictor for patients with acute myeloid leukemia in first remission: combined FHCRC and MDACC experiences
Mohamed L. Sorror*, Sergio Giralt, Brenda M. Sandmaier, Marcos De Lima, Munir Shahjahan, David G. Maloney, H Joachim Deeg, Frederick R. Appelbaum, Barry Storer, and Rainer Storb
Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, United States
Stem Cell Transplantation, M.D. Anderson Cancer Center, Houston, TX, United States
University of Washington, Seattle, WA, United States
* Corresponding author; email: msorror{at}fhcrc.org.
A new hematopoietic cell transplantation-specific comorbidity index (HCT-CI) was effective in predicting outcomes among patients with hematological malignancies given HCT at FHCRC. Here, we compared the performance of the HCT-CI to two other indices and then tested its capacity to predict outcomes among two cohorts of patients diagnosed with a single disease entity, acute myeloid leukemia in 1st complete remission, transplanted at either FHCRC or MDACC. FHCRC patients less frequently had unfavorable cytogenetics (15% versus 36%) and HCT-CI of  3 (21% versus 58%) compared to MDACC patients. We found that the HCT-CI had higher sensitivity and outcome predictability compared to the other indices among both cohorts. HCT-CI scores of 0, 1-2, and 3 predicted comparable non-relapse mortalities (NRM) among FHCRC and MDACC patients. In multivariate models, HCT-CI scores were associated with the highest hazard ratios for NRM and survival among each cohort. The 2-year survival rates among FHCRC and MDACC patients were 71% versus 56%, respectively. After adjustment for risk factors, including HCT-CI scores, no difference in survival was detected (HR: 0.98, p=0.94). The HCT-CI is a sensitive and informative tool to compare trial results at different institutions. Inclusion of comorbidity data in HCT trials provides valuable, independent information.
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