Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI)

Description

Sorror et al developed a comorbidity index (CI) that can be used for patients about to undergo a hematopoietic cell transplant (HCT). This can help identify patients who are at greater risk for complications. The authors are from the Fred Hutchinson Cancer Research Center in Seattle, Washington.

Parameters:

(1) cardiac arrhythmias (atrial fibrillation, atrial flutter, ventricular arrhythmia, sick sinus syndrome)

(2) cardiac valvular disorder

(3) other cardiac disease

(4) inflammatory bowel disease (Crohn's disease, ulcerative colitis)

(5) peptic ulcer

(6) diabetes

(7) cerebrovascular disease

(8) hepatic disease

(9) renal disease

(10) rheumatologic disorder (SLE(RA, polymyosisits, MCTD, polymyalgia rheumatica)

(11) infection

(12) obesity

(13) previous history of solid tumor (except nonmelanoma skin cancer)

(14) pulmonary disease

(15) psychiatric disorder (anxiety or depression requiring psychiatric consult or therapy)

Parameter	Finding	Points
cardiac arrhythmia	absent	0
	present	1
cardiac valvular disorder	absent	0
	mitral valve prolapse	0
	other	3
cardiac disease	absent	0
	present	1
inflammatory bowel disease	absent	0
	present	1
peptic ulcer	absent	0
	not requiring treatment	0
	requires treatment	2
diabetes	absent	0
	managed by diet alone	0
	treated with oral drugs or insulin	1
cerebrovascular disease	absent	0
	TIA and/or stroke	1
hepatic disease	none	0
	mild	1
	moderate or severe	3
renal disease	none	0
	mild	0
	moderate or severe	2
rheumatologic disorder	absent	0
	present	2
infection	absent	0
	not requiring therapy	0
	requires antimicrobial therapy after day 1	1
obesity	BMI <= 35 kg per square meter	0
	> 35 kg per square meter	1
previous history of solid tumor	absent	0
	present	3
pulmonary disease	none	0
	mild	0
	moderate	2
	severe	3
psychiatric disorder	absent	0
	present	1

where:

• Other cardiac disease includes CHF, left ventricular ejection fraction <= 50%, coronary artery disease involving one or more arteries, or myocardial infarction.

• Moderate to severe renal: serum creatinine > 2 mg/dL, on dialysis, or history of renal transplantation

• Moderate pulmonary: DLco 66-80% of predicted; FEV1 66-80% of predicted; dyspnea on slight activity

• Severe pulmonary: DLco <= 65% of predicted; FEC1 <= 65% of predicted; dyspnea at rest; requires oxygen

• Mild hepatic: chronic hepatitis; total serum bilirubin from 1.01 to 1.5 times ULN; transaminases 1.01 to 2.5 times ULN (upper limit of normal)

• Moderate to severe hepatic disease: cirrhosis; total serum bilirubin > 1.5 times ULN; transaminases > 2.5 times ULN.

total HCT-CI =

= SUM(points for all of the parameters)

Interpretation:

• minimum HCT-CI: 0

• maximum HCT-CI: 26

• A patient with a HCT-CI >= 3 had a 2 year non-relapse mortality rate of 40%, which was twice that for a person with a HCT-CI <=2.

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Description

Objective

ICD-10

Hematopoietic Cell Transplantation Comorbidity Index (HCT-CI)

Purpose: To evaluate a patient prior to a hematopoietic cell transplant (HCT) using the comorbidity index of Sorror et al (HCT-CI).

Description

Objective

ICD-10