Design and Validation of an Augmented Hematopoietic Cell Transplantation-Comorbidity Index Comprising Pretransplant Ferritin, Albumin, and Platelet Count for Prediction of Outcomes after Allogeneic Transplantation

Jennifer E. Vaughn, Barry E. Storer, Philippe Armand, Roberto Raimondi, Christopher Gibson, Alessandro Rambaldi, Fabio Ciceri, Rosi Oneto, Benedetto Bruno, Paul J. Martin, Brenda M. Sandmaier, Rainer Storb, Mohamed L. Sorror

Research output: Contribution to journalArticle

Abstract

Pretransplant values of serum ferritin, albumin, and peripheral blood counts were previously suggested to provide prognostic information about hematopoietic cell transplantation (HCT) outcomes. Whether these "biomarkers" have prognostic value independent of each other and the HCT-comorbidity index (HCT-CI) is unknown. We analyzed data from 3917 allogeneic HCT recipients at multiple sites in the United States and Italy using multivariate models including each biomarker and the HCT-CI. Data from all sites were then randomly divided into a training set (n= 2352) to develop weights for the relevant biomarkers to be added to the HCT-CI scores and a validation set (n= 1407) to validate an augmented HCT-CI compared with the original index. Multivariate analysis with data from one site showed that ferritin, albumin, and platelets-not neutrophils or hemoglobin-were independently associated with increased nonrelapse mortality (NRM) and decreased overall survival. Findings were validated in data from the other sites. Subsequently, in a training set from all sites, ferritin >2500 mg/dL (hazard ratio [HR], 1.69); albumin 3 to 3.5 g/dL (HR, 1.61) and

Original languageEnglish
Pages (from-to)1418-1424
Number of pages7
JournalBiology of Blood and Marrow Transplantation
Volume21
Issue number8
DOIs
Publication statusPublished - Aug 1 2015

Keywords

  • Albumin
  • Biomarkers
  • Ferritin
  • HCT-CI
  • HCT-comorbidity index
  • Hematopoietic cell transplantation
  • Platelet count survival

ASJC Scopus subject areas

  • Transplantation
  • Hematology

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