Comorbidity Index in Predicting Toxicity and Mortality Risk among Patient Undergoing Hematopoietic Stem Cell Transplantation

Abstract

ABSTRACT Recent advances in hematopoietic stem cell transplantation have led to accessibility of this modality to many patients, who were earlier ineligible like older patients who tend to have been more heavily pretreated and have more comorbidities. Thus, the evaluation of comorbidity is of increasing importance to more precisely assess the benefits and risks of the transplantation procedure Aim: Assess comorbidity index in predicting toxicity and mortality risk among patient undergoing hematopoietic stem cell transplantation. Study design: Retrospective design was utilized to conduct this study. Subject: A purposive sample of 44 patients undergoing allogeneic hematopoietic stem cell transplantation was recruited in this study. Setting: This study conducted at the bone marrow transplantation unit in Nasser institute for research and treatment. Tools: Tool I. Personal and medical related data, Tools II. The hematopoietic stem cell transplantation specific-comorbidity index (HCT-CI) and Tools III Seattle criteria for organ toxicity after bone marrow transplantation. Results: The mean age of the studied patients were 39.09±5.46, 61.4% were male and 34.1% were pre university education. Also, there was a positive correlation between comorbidity, organ toxicity and total mortality post bone marrow transplantation at p value 0.01. Conclusion: As there was a positive correlation between patient’s comorbidity (obesity, cerebrovascular disease, cardiac disease, infection, renal disease, prior malignancy, hepatic disease and psychiatric disorder) and total toxicity and mortality post bone marrow transplantation, so, the comorbidity index is an important tool to predict toxicity and mortality rate among patient undergoing hematopoietic stem cell transplantation. Recommendations: Apply comorbidity index in predicting toxicity and mortality risk among patient undergoing hematopoietic stem cell transplantation.