Assesment of non-relapse mortality (NRM) and long-term survival after autologous stem cell transplantation (ASCT) in patients with lymphoproliferative diseases

Abstract

A balanced risk-benefit approach to haematopoietic stem cell transplantation (HSCT) is the key for maximized chances of cure with acceptable quality of life for patients with advanced haematological malignancies. The aim was to try to assess the prognostic value of comorbidity and other independent variables concerning pretransplant mobilization strategies that affect auto SCT in patients with lymphoproliferative diseases.We stratified outcomes among 90 consecutive adult autologous recipients with lymphoproliferative diseases. 55% of patients were classified in the low index group for haematopoietic stem cell transplantation with comorbidity index (HCT-CI) scores between 0-1, 27% of patients with lymphoproliferative diseases had intermediate HCT-CI scores 1-2 and 12% of patients were in high HCT-CI group with a score≥3 and 6% undetermined. Two year NRM was 36% (95% CI: 17-36%), 26% (95% CI 15-39%) and 30% (95% CI: 22-39%) in the low, intermediate and high-risk HCT-CI groups respectively. The HCT-CI has been shown to sensitively capture organ comorbidities and provide valuable prognostic information for assignments of patients to clinical trials. Still, many questions remain to be answered, auch as good sample size, equal stratification of patients into risk groups, and also implementing better pretransplant assessment.