Characterization of cancer comorbidity prior to allogeneic hematopoietic cell transplantation.

Abstract

Higher comorbidity by the hematopoietic cell transplantation-comorbidity index increases rates of non-relapse mortality (NRM) and impairs survival following allogeneic hematopoietic transplantation. We explored the effects of cancer as a comorbid condition prior to allogeneic transplantation. Among 356 adult transplant recipients, 54 patients (15%) had 58 comorbid cancers. Among 33 solid cancers (9%), breast (n = 12; 20%) was most common; among 26 comorbid hematologic malignancies (i.e. separate hematologic malignancy not related to primary disease) (7%), lymphoma was most common (n = 14; 24%). In unadjusted analysis, increased risks for NRM were found for cancer comorbidity (HR 2.1, p < .001), solid tumor alone (HR 2.1, p < .001), and hematologic malignancy alone (HR 1.9, p = .03). Cancer comorbidity did not impair 2-year overall survival (HR 1.33, CI 0.92-1.94). Both hematologic and solid cancers likely contribute to elevated risks of nonrelapse mortality, unrelated to recurrence of the cancer comorbidity. Further study is indicated to validate these findings.

• Authors: Christopher R D'Angelo, Brianna Novitsky, Sang Mee Lee, Lucy A Godley, Justin Kline, Richard A Larson, Hongtao Liu, Olatoyosi Odenike, Wendy Stock, Michael R Bishop, Andrew S Artz
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 60 Issue 3 Pg. 629-638 (03 2019) ISSN: 1029-2403 [Electronic] United States
• PMID: 30070150 (Publication Type: Journal Article)

Topics

• Aged
• Aged, 80 and over
• Cause of Death
• Comorbidity
• Female
• Hematopoietic Stem Cell Transplantation (adverse effects, methods)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Neoplasms (epidemiology, pathology, therapy)
• Preoperative Period
• Prevalence
• Prognosis
• Risk Factors
• Transplantation Conditioning
• Transplantation, Homologous
• Treatment Outcome