期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 14, 期 9, 页码 1039-1044出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2008.06.019
关键词
comorbidity; multiple myeloma; autologous hematopoietic stem cell transplantation; transplantation-related toxicity
资金
- Ottawa Hospital Foundation BMT Education and Research Fund
- Roche Pharmaceuticals
- University of Ottawa Centre for Transfusion Research Fellowship
- Canadian Blood Services
Patients with coexisting medical problems may suffer increased toxicity and reduced quality of life after autologous hematopoietic stem cell transplantation (HSCT). The benefit of high-dose therapy for some patients with multiple myeloma (MM) is debatable. Decision tools that aid in identifying those patients with MM most suited for autologous HSCT may avoid the risk of excess toxicity. An objective assessment of comorbidities was performed in 126 patients with MM undergoing autologous HSCT using the Charlson comorbidity index (CCI), the hematopoietic cell transplantation comorbidity index (HCT-CI), and a modified pretransplantation assessment of mortality (mPAM) to determine the strength of association with increased transplantation-related toxicity and increased length of hospital stay (LOS). Any comorbidity scored using the CCI or HCT-CI (score > 0) was associated with an increased number of organ systems with serious toxicity (at least grade 2 toxicity using the Seattle criteria), an increased total sum of toxicity grades for all organs, and prolonged LOS. Am mPAM score ! 24 was associated with increased LOS. When considering autologous HSCT for a patient with MM, assessment of comorbidities using the CCI or HCT-CI may assist in predicting the risk of transplantation-related toxicity as an adjunct to physician judgment and patient preference. (C) 2008 American Society for Blood and Marrow Transplantation.
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