Backhaus D, Brauer D, Pointner R, et al. A High Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI) Does Not Impair Outcomes After Non-Myeloablative Allogeneic Stem Cell Transplantation in Acute Myeloid Leukemia Patients 60 Years or Older. Bone Marrow Transplantation. 2022; (doi: 10.1038/s41409-022-01833-0).
New research shows that for older patients with acute myeloid leukemia (AML) who received non-myeloablative conditioning-allogeneic hematopoietic stem cell transplantation (NMA-HSCT), a higher hematopoietic cell transplantation comorbidity index (HCT-CI) did not have a meaningful impact on outcomes. The study involved 289 AML patients aged 60 years and older who had NMA-HSCT, consisting of 2 or 3 Gray total body irradiation and 3 days of fludarabine 30 mg/m2. HCT-CI risk was low for 36% of the patients, intermediate for 31%, and high for 33%. Between HCT-CI groups, there was no difference in non-relapse mortality, cumulative incidence of relapse, and overall survival (OS), nor did the HCT-CI affect outcomes in terms of the European LeukemiaNet 2017 risk at diagnosis or the measurable residual disease (MRD) status at HSCT. Patients who achieved a MRD-negative status at HSCT saw a median OS of 49% at 5 years. Based on their findings, the researchers conclude that since a high HCT-CI did not impact outcomes, neither age or comorbidities should preclude considering NMA-HSCT as a feasible consolidation option for this group of AML patients."