Publication Date:
2011-11-18
Description:
Abstract 2091 Autologous stem cell transplant (ASCT) is the treatment of choice for relapsed aggressive histology Non-Hodgkin's lymphoma (NHL) and is part of first line therapy for mantle cell lymphoma (MCL). Although treatment related morbidity and mortality from ASCT is considerably less than for allogeneic transplant, it is not without risk and can be affected by comorbid conditions. Two comorbidity scores have been used for stem cell transplant patients to assess risk, the Charlson Comorbidity Index (CCI) (Biol Blood Marrow Transplant 2008;14:840-6) and the Hematopoietic Stem Cell Transplantation Comorbidity Index (HCT-CI) (Blood 2005;106:2912-19). The Cumulative Illness Rating- Geriatric Severity Index (CIRS-G SI) has also been used in patients with cancer (J Clin Oncol 1998;16:1582-7). This project compares these comorbidity scores and examines the effect of comorbid conditions on outcomes post transplant. A retrospective chart review was performed on 101 patients with NHL receiving ASCT from 2003 to 2010 at our institution. Patients were conditioned using BEAM chemotherapy (BCNU, etoposide, cytarabine, melphalan). Variables collected included age, gender, diagnosis, international prognostic index (IPI), comorbidity scores, length of stay (LOS) and overall survival. The length of stay was calculated as the extra LOS (ELOS) beyond day 14 to account for some patients who were able to be discharged early for proximity reasons. Correlations were calculated using the Pearson Correlation Coefficient. Linear and Cox regression were used in the analysis. The median age of the patient population was 57 years (range 26–68 years) and 38% were female. The majority of patients had diffuse large B cell lymphoma (DLBCL) 57%, other histological subtypes included MCL 10%, follicular lymphoma (FL) 10%, transformed FL 7% and others 16%. The median follow-up time was 17.2 months (0.5–96 months) for the entire group, and 28 months (0.5–83) for the DLBCL group. For the DLBCL group, the international prognostic index (IPI) at diagnosis was 0–1 in 67% and 2–5 in 33%. The IPI at relapse was 0–1 in 55% and 2–5 in 45%. The median number of reinfused stem cells was 4.9 × 106 CD34+/ kg (range 1.7–27). The median score on the CCI was 2 (range 2–5), 73% of patients had CCI score of 2 or less, 23% had score of 3 and 4% had a score 4 or greater. The median score on the CIRS-G SI was 3 (range 1.6 – 4). The median score on the HCT-CI was 0 (range 0–5), 66% had a score of 0, 27% had a score of 1 or 2, and 7% had a score of at least 3. The Pearson correlation between the CCI and HCT-CI was 0.8 (p
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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