A novel Iowa–Mayo validated composite risk assessment tool for allogeneic stem cell transplantation survival outcome prediction

Abstract

Allogeneic hematopoietic stem cell transplantation (HSCT) is a curative option for many hematologic conditions and is associated with considerable morbidity and mortality. Therefore, prognostic tools are essential to navigate the complex patient, disease, donor, and transplant characteristics that differentially influence outcomes. We developed a novel, comprehensive composite prognostic tool. Using a lasso-penalized Cox regression model (n = 273), performance status, HCT-CI, refined disease-risk index (rDRI), donor and recipient CMV status, and donor age were identified as predictors of disease-free survival (DFS). The results for overall survival (OS) were similar except for recipient CMV status not being included in the model. Models were validated in an external dataset (n = 378) and resulted in a c-statistic of 0.61 and 0.62 for DFS and OS, respectively. Importantly, this tool incorporates donor age as a variable, which has an important role in HSCT outcomes. This needs to be further studied in prospective models. An easy-to-use and a web-based nomogram can be accessed here: https://allohsctsurvivalcalc.iowa.uiowa.edu/.

Risk factors for fatal cardiac complications after allogeneic hematopoietic cell transplantation: Japanese Society for Transplantation and Cellular Therapy transplant complications working group

“…The non‐relapse mortality (NRM) rate was high in patients with poor PS; such mortality is common due to both cardiac and other complications. Recently, the HCT‐CI, which includes 17 comorbidities, was identified as a useful predictor of NRM 32,33 . Although cardiac function is generally assessed in patients scheduled for HCT, predicting severe cardiac complications by electrocardiogram or echocardiography may be difficult 8,34,35 .…”

“…The non-relapse mortality (NRM) rate was high in patients with poor PS; such mortality is common due to both cardiac and other complications. Recently, the HCT-CI, which includes 17 comorbidities, was identified as a useful predictor of NRM 32,33. Although cardiac Cumulative incidence of death due to cardiac complications after hematopoietic cell transplantation (HCT).…”