Year: 2017
Type: Proceeding article
Title: Outcome after autologous transplantation in the terms of comorbidity for patients with lymphoproliferative diseases: Single center experience
Author: Pivkova Veljanovska, Aleksandra
Author: Genadieva-Stavrik, Sonja Genco
Author: Stojanoski, Zlate
Author: Chadievski, Lazar
Author: Panovska Stavridis, Irina
Author: Trajkova, Sanja
Author: Cevreska, Lidija
Author: Georgievski, Borche
Abstract: Background: Autologous stem cell transplantation (ASCT) improves survival in patients with myeloma and lymphoma but is associated with morbidity and nonrelapse mortality (NRM). Hematopoietic cell transplant comorbidity index (HCT-CI) was shown to predict risk of NRM and survival after allogeneic transplantation. We tested the utility of HCT-CI as a predictor of NRM and overall survival (OS) in patients undergoing ASCT. Methods: We analyzed outcomes of 220 patients after high-dose melphalan and high –dose anti lymphoma chemotherapy during year 2000 to 2015. Individual comorbidities were prospectively collected at the time of ASCT. The impact of HCT-CI and other potential prognostic factors, including Karnofsky performance score (KPS), on NRM and survival were studied in multivariate Cox regression models. Results: HCT-CI score was 0, 1, 2, 3, and >3 in 42%, 18%, 13%, 13%, and 14% of the study cohort, respectively. Subjects were stratified into 3 risk groups: HCT-CI score of 0 (42%) versus HCT-CI score of 1 to 2 (32%) versus HCT-CI score > 2 (26%). Higher HCT-CI was associated with lower KPS < 90 (33% of subject’s score of 0 versus 50% in HCT-CI score > 2). HCT-CI score > 2 was associated with melphalan dose reduction (22% versus 10% in score 0 cohorts). One-year NRM was low at 2% (95% confidence interval, 1% to 4%). On multivariate analysis, overall survival was inferior in groups with HCT-CI score of 1 to 2 (relative risk, 1.37, [95% confidence interval, 1.01 to 1.87], P = .04) and HCT-CI score > 2 (relative risk, 1.5 [95% confidence interval, 1.09 to 2.08], P = .01). Factors that affect OS in the autologous recipients among lymphoma and myeloma patients were: HCT-CI, Karnofsky score, number of CD34+ cells/kg and time from diagnosis until transplant (p<0.05). Factors that affect TRM/NRM were HCT-CI, ECOG, Karnofsky score and number of hospital days and body weight.(p<0.05). Conclusions: ASCT for MM and lymphoma is associated with low NRM, and death is predominantly related to disease progression. Comorbidity evaluation during autologous transplantation for lymphoproliferative diseases can be a useful tool in predicting transplant outcome.
Publisher: American Society of Clinical Oncology (ASCO)
Relation: Journal of Clinical Oncology
Identifier: oai:repository.ukim.mk:20.500.12188/15263
Identifier: http://hdl.handle.net/20.500.12188/15263Identifier: 10.1200/jco.2017.35.15_suppl.e19502
Identifier: http://ascopubs.org/doi/pdfdirect/10.1200/JCO.2017.35.15_suppl.e19502Identifier: 35
Identifier: 15_suppl
Identifier: e19502
Identifier: e19502
