Performance Status and Comorbidity Predict Transplant-Related Mortality After Allogeneic Hematopoietic Cell Transplantation

Andrew S. Artz*, Daniel A. Pollyea, Masha Kocherginsky, Wendy Stock, Elizabeth Rich, Olatoyosi Odenike, Todd Zimmerman, Sonali Smith, Lucy Godley, Michael Thirman, Christopher Daugherty, Martine Extermann, Richard Larson, Koen van Besien

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


Comorbidity measurements have recently been used to improve estimation of tolerance to allogeneic hematopoietic cell transplantation (HCT). We sought to determine the independent effect of comorbidity and performance status on HCT outcome and to devise a simple risk classification system for transplant-related mortality. We analyzed 105 consecutively enrolled patients who underwent HCT and received reduced intensity conditioning with fludarabine, melphalan, and alemtuzumab. Comorbid conditions were tabulated using 2 scales, the Charlson Comorbidity Index (CCI) and the Kaplan-Feinstein Scale (KFS). Comorbid conditions were found in 47% of patients by the KFS and in 27% by the CCI (P < .001). Using the Eastern Cooperative Oncology Group Performance Status (PS) scale, 34% had a PS score >0 (range, 0-2). A simple scale combining the KFS and PS enabled separation of high- from low-risk patients, with 6-month cumulative incidences 50% and 15%, respectively for transplant-related mortality (P = .001) and enhanced prognostic power over the CCI alone (P = .018). Prospective studies evaluating more comprehensive functional and comorbidity measurements are warranted.

Original languageEnglish (US)
Pages (from-to)954-964
Number of pages11
JournalBiology of Blood and Marrow Transplantation
Issue number9
StatePublished - Sep 2006


  • Allogeneic transplantation
  • Comorbidity
  • Elderly
  • Functional status
  • Leukemia

ASJC Scopus subject areas

  • Hematology
  • Transplantation


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