부산대학교 도서관

Simple Summary: This study aimed to create a simple and reliable tool, the CORE HCT score, to predict the chances of non-relapse mortality (NRM) and overall survival (OS) after allogeneic hematopoietic stem cell transplantation (allo-HCT). Using data from 1120 adult patients who had undergone this procedure at our center between 2013 and 2020, we identified specific patient factors affecting NRM: serum albumin, serum creatinine, serum C-reactive protein, heart and lung function, and age. Factors were weighted according to their impact on NRM. The resulting CORE HCT score grouped patients into low-, medium-, and high-risk categories, showing its effectiveness across different conditions and donor types. Notably, compared with the HCT Comorbidity Index (HCT-CI), the CORE HCT score performed better in predicting NRM and OS. The findings were validated in two independent cohorts, which supports the utility of the CORE HCT score in guiding risk assessment for allo-HCT in adult patients with malignant diseases. We aimed to develop a concise objectifiable risk evaluation (CORE) tool for predicting non-relapse mortality (NRM) and overall survival (OS) after allogeneic hematopoietic stem cell transplantation (allo-HCT). A total of 1120 adult patients who had undergone allo-HCT at our center between 2013 and 2020 were divided into training, first, and second validation cohorts. Objectifiable, patient-related factors impacting NRM in univariate and multivariate analyses were: serum albumin, serum creatinine, serum C-reactive protein (CRP), heart function (LVEF), lung function (VC, FEV1), and patient age. Hazard ratios were assigned points (0–3) based on their impact on NRM and summed to the individual CORE HCT score. The CORE HCT score stratified patients into three distinct low-, intermediate-, and high-risk groups with two-year NRM rates of 9%, 22%, and 46%, respectively, and OS rates of 73%, 55%, and 35%, respectively (p < 0.001). These findings were confirmed in a first and a second recently treated validation cohort. Importantly, the CORE HCT score remained informative across various conditioning intensities, disease-specific subgroups, and donor types, but did not impact relapse incidence. A comparison of CORE HCT vs. HCT Comorbidity Index (HCT-CI) in the second validation cohort revealed better performance of the CORE HCT score with c-statistics for NRM and OS of 0.666 (SE 0.05, p = 0.001) and 0.675 (SE 0.039, p < 0.001) vs. 0.431 (SE 0.057, p = 0.223) and 0.535 (SE 0.042, p = 0.411), respectively. The CORE HCT score is a concise and objectifiable risk evaluation tool for adult patients undergoing allo-HCT for malignant disease. External multicenter validation is underway. [ABSTRACT FROM AUTHOR]