Hematopoietic CELL Transplantation (HCT)-Specific Comorbidity INDEX in Autologous STEM CELL Transplant Indicates People with Advanced Age and Increased Comorbidity INDEX Should BE Hosptialized Through Engraftment

The hematopoietic cell transplantation specific comorbidity index (HCT-CI) has been proven to be a valuable tool in allogeneic stem cell transplant (ASCT) recipients to predict overall survival. There are few studies that use the HCT-CI for evaluating autologous stem cell transplantation. Our institution performs autologous stem cell transplants in a variety of settings, from completing the whole transplant process inpatient to instituting their preparative regimen through transplant and engraftment in the outpatient setting. We retrospectively reviewed our experience of 250 autologous stem cell transplants who had a diagnosis that included Multiple Myeloma, Non-Hodgkin’s Lymphoma, Hodgkin’s Lymphoma, and Testicular Carcinoma that were either treated inpatient for their hospital course or were prepared in the outpatient setting and/or were discharged very early in their transplant course (day-1 or within three days of their autologous transplant). The median age of the inpatient transplant group was 63.5 compared to the outpatient group that was 58, P<0.006. The average comorbidity index for the inpatient group was 2.086 compared to the outpatient group 1.23, P<0.001. In conclusion, our institution, using the HCT-CI and age for autologous stem cell transplantation helps to identify those candidates that are more successfully treated in the inpatient setting and the outpatient setting. This study was limited by its retrospective nature, small size and single center experience. Prospective randomized studies are needed to determine whether or not the HCT-CI in autologous stem cell transplantation is truly effective.