Q2. How many patients had prior myeloablative HCT?
Thirteen percent of patients had preceding myeloablative HCT, of which 2% were allogeneic, 6% were failed autologous, and 5% were planned autologous.
Q3. What was used instead of survival for the development of the scores?
NRM was used instead of survival for development of the scores, since deaths from nonrelapse causes are more likely influenced by pretransplant comorbidities than deaths caused by disease progression or relapse, which were treated as competing risks.
Q4. What was the primary modification of the HCT-CI?
The primary modification was refinement of several comorbidity definitions, which was done by introducing objective laboratory and functional testing data, thereby incorporating subclinical organ impairments that could result in partial compromise in patients subjected to the intensive physiologic challenge of HCT.
Q5. How many patients were assigned to a training set?
Two thirds of the patients were assigned to a training set to develop the scoring weights (n 708), and one third was assigned to a validation set (n 347).
Q6. What was the c-statistic for a continuous predictor?
For a continuous predictor, the c-statistic could be interpreted as the probability that a random pair of observations whose event times could be ordered would have a concordant ordering of the predictor.
Q7. What are the factors that should be considered when determining HCT risks?
Age and disease stage of a specific hematologic malignancy were additional factors that should be considered when determining HCT risks.
Q8. What were the frequent comorbidities in the new HCT-CI?
Pulmonary and hepatic abnormalities, as defined by laboratory data, were the most frequent comorbidities in the new HCT-CI and, together with prior solid tumor and heart valve disease, had the highest assigned weights.
Q9. What was the common cause of death among the 122 patients?
There were 347 patients with moderate (score 2) or severe (score 3) pulmonary comorbidities, and 122 died from nonrelapse causes.
Q10. What were the weights for comorbidities in the HCT-CI?
Of the 8 comorbidities tested that were not specified by Charlson, obesity, peritransplant infections, and psychiatric disturbances were assigned weights in the HCT-CI, whereas bleeding, headache, osteoarthritis, osteoporosis, and asthma were not because of low predictive HR for NRM (0.0, 0.3, 0.4, 0.7, and 1.1,n 1055.
Q11. What are the main reasons for the increase in the use of nonablative HCT?
With the development of nonmyeloablative HCT regimens and improvements in the supportive care after myeloablative HCT regimens, more patients with comorbidities are being offered allogeneic HCT.
Q12. What were the main factors that played a significant role in the HCT-CI?
Even though the HCT-CI scores were highly effective in predicting outcome of patients after HCT, other major pretransplant factors played significant roles.
Q13. How many comorbidities are there in the SEER registry?
In Surveillance, Epidemiology, and End Results (SEER) registry data, 75% of patients 55 years and older with colon cancer had more than one comorbidity.
Q14. What was the main change for increasing the sensitivity of the new HCT-CI?
This introduction of laboratory data constituted the main change for increasing the sensitivity of the new HCT-CI, in particular since pulmonary and hepatic comorbidities achieved the highest prevalence among their transplant populations.
Q15. What causes of death were found in the 122 patients with GVHD?
Causes of NRM among these 122 patients included pulmonary toxicities (24%), GVHD (11%), and infections (45%) with (18%) or without (27%) GVHD (infections involved the lungs in almost half of the cases), and 20% died from other causes.
Q16. How many bootstrap samples were used to estimate the c-statistic?
Standard errors for the c-statistic were estimated by applying a bootstrap procedure to the validation dataset, using 100 bootstrap samples.
Q17. What was the main change for the improvement of the HCT-CI over the original CCI?
The use of laboratory data in the new HCT-CI accounted for larger numbers of patients with scored comorbidities, which added to the utility of the new HCT-CI over the original CCI.