ToolsCalculators
Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI)
Pretransplant comorbidity burden predicting non-relapse mortality after allogeneic HCT.
Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI)
Arrhythmia (atrial fibrillation/flutter, sick sinus syndrome, ventricular arrhythmia)
Cardiac disease (CAD, CHF, MI, or EF <=50%)
Inflammatory bowel disease (Crohn disease or ulcerative colitis)
Diabetes requiring insulin or oral hypoglycemics
Cerebrovascular disease (TIA or CVA)
Psychiatric disturbance requiring consultation or treatment
Mild hepatic disease (chronic hepatitis, bilirubin >ULN-1.5x ULN, or AST/ALT >ULN-2.5x ULN)
Obesity (BMI >35 kg/m^2)
Infection requiring continued antimicrobial treatment after day 0
Rheumatologic disease (SLE, RA, polymyositis, mixed connective tissue disease, polymyalgia rheumatica)
Peptic ulcer disease requiring treatment
Moderate/severe renal disease (creatinine >2 mg/dL, on dialysis, or prior renal transplant)
Moderate pulmonary disease (DLCO and/or FEV1 66-80%, or dyspnoea on slight activity)
Prior solid tumour (treated at any time in the past, excluding non-melanoma skin cancer)
Heart valve disease (prosthetic valve or moderate/severe stenosis or regurgitation)
Severe pulmonary disease (DLCO and/or FEV1 <=65%, dyspnoea at rest, or need for oxygen)
Moderate/severe hepatic disease (cirrhosis, bilirubin >1.5x ULN, or AST/ALT >2.5x ULN)
Result0 points
Low comorbidity burden; higher scores are associated with progressively greater non-relapse mortality and lower overall survival after allogeneic HCT.
- Comorbidity risk group
- Low
When to use
- Quantifying pretransplant comorbidity burden to inform conditioning-intensity choice and estimate non-relapse mortality risk before allogeneic HCT.
Formula
Sum of weighted comorbidities: 1 point each for arrhythmia, prior cardiac disease, inflammatory bowel disease, diabetes, cerebrovascular disease, psychiatric disturbance, mild hepatic disease, obesity, infection; 2 points each for rheumatologic disease, peptic ulcer disease, moderate renal disease, moderate pulmonary disease; 3 points each for prior solid tumour, heart valve disease, severe pulmonary disease, moderate/severe hepatic disease. Groups: Low 0, Intermediate 1-2, High >=3.
Pearls and pitfalls
- Developed to replace the general Charlson Comorbidity Index with HCT-specific weighting and organ-function thresholds.