دورية أكاديمية
Expanded HCT-CI Definitions Capture Comorbidity Better for Younger Patients of Allogeneic HCT for Nonmalignant Diseases.
| العنوان: | Expanded HCT-CI Definitions Capture Comorbidity Better for Younger Patients of Allogeneic HCT for Nonmalignant Diseases. |
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| المؤلفون: | Broglie L; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin., Friend BD; Baylor College of Medicine, Center for Cell and Gene Therapy, Houston, Texas., Chhabra S; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin; Division of Hematology/Oncology, Department of Medicine, Mayo Clinic Arizona, Phoenix, Arizona. Electronic address: Chhabra.Saurabh@mayo.edu., Logan BR; Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, Wisconsin; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Bupp C; CIBMTR (Center for International Blood and Marrow Transplant Research), National Marrow Donor Program/Be The Match, Minneapolis, Minnesota., Schiller G; Hematological Malignancy/Stem Cell Transplant Program, David Geffen School of Medicine at UCLA, Los Angeles, California., Savani BN; Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee., Stadtmauer E; University of Pennsylvania Abramson Cancer Center, Philadelphia, Pennsylvania., Abraham AA; Center for Cancer and Immunology Research, Division of Blood and Marrow Transplantation, Children's National Hospital, Washington, District of Columbia., Aljurf M; Department of Oncology, King Faisal Specialist Hospital Center & Research, Riyadh, Saudi Arabia., Badawy SM; Division of Hematology, Oncology and Stem Cell Transplant, Ann & Robert H. Lurie Children's Hospital of Chicago, Illinois; Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois., Perez MAD; Department of Hematology/Oncology, Hospital Infantil Universitario Niño Jesus, Madrid, Spain., Guinan EC; Departments of Pediatric and Radiation Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts., Hashem H; Division of Pediatric Hematology/Oncology and Bone Marrow Transplantation, King Hussein Cancer Center, Amman, Jordan., Krem MM; Kansas City VA Medical Center, Kansas City, Missouri., Lazarus HM; University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio., Rotz SJ; Department of Pediatric Hematology, Oncology, and Blood and Marrow Transplantation, Cleveland Clinic Children's Hospital, Cleveland, Ohio., Wirk B; Bone Marrow Transplant Program, Penn State Cancer Institute, Hershey, Pennsylvania., Yared JA; Transplantation & Cellular Therapy Program, Division of Hematology/Oncology, Department of Medicine, Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, Maryland., Pasquini M; CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin., Thakar MS; Clinical Research Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington; Division of Pediatric Hematology-Oncology, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington., Sorror ML; Clinical Research Division, Fred Hutchinson Cancer Center, University of Washington, Seattle, Washington; Division of Medical Oncology, Department of Medicine, University of Washington School of Medicine, Seattle, Washington. |
| المصدر: | Transplantation and cellular therapy [Transplant Cell Ther] 2023 Feb; Vol. 29 (2), pp. 125.e1-125.e9. Date of Electronic Publication: 2022 Nov 25. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Inc Country of Publication: United States NLM ID: 101774629 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2666-6367 (Electronic) Linking ISSN: 26666367 NLM ISO Abbreviation: Transplant Cell Ther Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: [New York] : Elsevier Inc., [2021]- |
| مواضيع طبية MeSH: | Thinness*/etiology , Hematopoietic Stem Cell Transplantation*/adverse effects, Adolescent ; Young Adult ; Humans ; Child ; Adult ; Transplantation, Homologous ; Prognosis ; Retrospective Studies ; Comorbidity ; Obesity/epidemiology ; Obesity/therapy ; Obesity/etiology |
| مستخلص: | Allogeneic hematopoietic cell transplantation (HCT) can cure many nonmalignant conditions, but concern for morbidity and mortality remains. To help physicians estimate patient-specific transplant mortality risk, the HCT comorbidity index (HCT-CI) is used. However, pediatric physicians use the HCT-CI less frequently than adult counterparts. We used the Center for International Blood and Marrow Transplant Research database to expand the HCT-CI comorbidity definitions to be more inclusive of children and adolescent and young adult (AYA) patients, adding history of mechanical ventilation, history of invasive fungal infection, assessment of chronic kidney disease (CKD) by estimated glomerular filtration rate, expanding the definition of obesity, and adding an underweight category. A total of 2815 children and AYAs (<40 years old) who received first allogeneic HCT for nonmalignant diseases from 2008 to 2017 were included to create an expanded youth nonmalignant HCT-CI (expanded ynHCT-CI) and a simplified non-malignant (simplified ynHCT-CI) HCT-CI. The expanded comorbidities occurred frequently-history of mechanical ventilation (9.6%), history of invasive fungal infection (5.9%), mild CKD (12.2%), moderate/severe CKD (2.1%), obesity (10.9%), and underweight (14.5%). Thirty-nine percent of patients had an increase in their comorbidity score using the expanded ynHCT-CI, leading to a redistribution of scores: ynHCT-CI score 0 (35%), 1-2 (36.4%), and ≥3 (28.6%). Patients with an increase in their comorbidity score had an increased hazard of mortality compared to those whose score remained the same (hazard ratio = 1.41; 95% confidence interval, 1.01-1.98). Modifications to the HCT-CI can benefit children and AYA patients with nonmalignant diseases, creating a risk assessment tool that is clinically relevant and better captures comorbidity in this younger population. (Copyright © 2022 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.) |
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| معلومات مُعتمدة: | U24 CA076518 United States CA NCI NIH HHS; UM1 AI109565 United States AI NIAID NIH HHS |
| فهرسة مساهمة: | Keywords: Allogeneic hematopoietic cell transplantation; Comorbidities; HCT-CI; Nonmalignant diseases; Pediatric adolescents and young adults (AYA) |
| تواريخ الأحداث: | Date Created: 20221128 Date Completed: 20230213 Latest Revision: 20240202 |
| رمز التحديث: | 20240202 |
| مُعرف محوري في PubMed: | PMC9911359 |
| DOI: | 10.1016/j.jtct.2022.11.020 |
| PMID: | 36442768 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 2666-6367 |
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| DOI: | 10.1016/j.jtct.2022.11.020 |