AML most commonly occurs in older adults. Predictors of chemotherapy tolerance are sorely needed. The haematopoietic cell transplantation comorbidity index (HCT-CI) has been validated to predict outcomes after allogeneic hematopoietic transplant. Using this index, Giles and colleagues studied 177 adults 60 years and over who received a uniform induction regimen of idarubicin and cytarabine. HCT-CI scores of 0, 1-2, and 3 were found in 22%, 30% and 48% of participants. Early death occurred 3% scoring a 0, 11% scoring 1-2, and 29% scoring a 3 or higher (P < 0.001). Lower median overall survival also correlated with higher HCT-CI scores. More comorbidity as defined by the HCT-CI is predicted for more early death and inferior overall survival for older AML patients receiving induction chemotherapy. Future studies are needed to validate this index and assess the additive value of functional status.Source:
F. Giles, et al. Br. J. Haematology. 2007;136:624-626.