Clinical comorbidity predictive measures in ex vivo T-cell-depleted allogeneic hematopoietic stem cell transplantation

Comorbidity scores have improved our ability to predict the outcome after T-cell-replete allogeneic hematopoietic stem cell transplantation (HCT).1 Prediction tools such as the Sorror Hematopoietic Cell Transplantation-Specific Comorbidity Index (HCT-CI) have been developed and validated in conventional T-replete HCT.2, 3, 4 Ex vivo T-cell depletion (TCD) of the graft improves the tolerability of HCT and may be affected differently by factors determined to affect the T-cell-replete HCT outcome.5, 6 The European Group for Blood and Marrow Transplantation (EBMT) risk scores may be used to assign risks of conventional T-replete HCT to an individual patient.7 Lodewyck et al.8 evaluated the utility of the EBMT score in T-cell-depleted unrelated donor transplantation for acute leukemia and myelodysplasia. Peripheral blood absolute lymphocyte/monocyte ratio (LMR) has also been shown to predict clinical outcomes in patients with lymphoma receiving autologous HCT. We therefore evaluated published comorbidity measures and other standard clinical biomarkers of outcome in a series of patients with hematologic malignancies undergoing myeloablative TCD transplants.