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The hematopoietic comorbidity risk index (HCT-CI) is a pre-transplant risk assessment tool used to qualify comorbidities to predict non-relapse mortality (NRM) of patients undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). HSCT procedures continue to improve. Therefore, the predictive value of HCT-CI needs to be re-evaluated. Our study is a retrospective analysis of pre-existing comorbidities assessing the relevance of the HCT-CI on the outcome of consecutive patients (n = 1102) undergoing allo-HSCT from 2006-2021. HCT-CI was classified as low (HCT-CI 0), intermediate (HCT-CI 1-2) and high-risk (HCT-CI ≥ 3). At 10 years, NRM for low, intermediate, and high-risk HCT-CI group was 21.0%, 26.0%, and 25.8% (p = 0.04). NRM difference was significant between low to intermediate (p < 0.001), but not between intermediate to high-risk HCT-CI (p = 0.22). Overall survival (OS) at 10 years differed significantly with 49.9%, 39.8%, and 31.1%, respectively (p < 0.001). In multivariate analysis of HCT-CI organ subgroups, cardiac disease was most strongly associated with NRM (HR = 1.73, p = 0.02) and OS (HR = 1.77, p < 0.001). All other individual organ comorbidities influenced NRM to a lesser extent. Further, donor (HR = 2.20, p < 0.001 for unrelated and HR = 2.17, p = 0.004 for mismatched related donor), disease status (HR = 1.41, p = 0.03 for advanced disease) and previous HSCT (HR = 1.55, p = 0.009) were associated with NRM. Improvement in transplant techniques and supportive care may have improved outcome with respect to comorbidities., (© 2024. The Author(s).)

Background: The aim of our study was to assess how often deep vein thrombosis (DVT) occurs bilaterally and if this has an impact on the recurrence rate of thromboembolic disease and on the occurrence of malignant tumors. Additionally, the occurrence of pulmonary embolism and mortality of patients was assessed. Patients and methods: For this observational study, we retrospectively screened all patient's records for DVT, investigated between 2000 and 2017. 2409 patients with the diagnosis of DVT were found. The patients aged between 18 and 89 years old in 2017, received a follow-up questionnaire, asking for thromboembolic recurrence, malignant tumors and pulmonary embolism. 755 patients were included in the follow-up cohort (604 with unilateral, 151 with bilateral DVT). We performed nonparametric tests to assess two group analysis. Results: Bilateral DVT occurred in 19% of the patients in this cohort. Patients with bilateral DVT develop significantly more often cancer, either at the time of diagnosis or in the follow up, compared to patients with unilateral DVT (22.5% vs. 15.4%, p=0.036). They also endure significantly more often pulmonary embolism simultaneously (33.8% vs. 20.8%, p<0.001). Patients with bilateral DVT were significantly older (median 69 years) than patients with unilateral DVT (median 63 years, p<0.001). In addition, patients with bilateral DVT show a higher mortality (9.1% vs. 5.2%, p=0.002), a higher recurrence rate could not be observed. Conclusions: Bilateral DVT is more common than published so far. Patients with bilateral DVT suffer more often from malignant tumors, and are more often diagnosed with pulmonary embolism. The patients with bilateral DVT are older and have a higher mortality. Further investigations should address the issue of recurrent thromboembolic disease in a prospective cohort study.