Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation: N. Farhadfar et al

Nosha Farhadfar; Ajoy Dias; Tao Wang; Caitrin Fretham; Saurabh Chhabra; Hemant S. Murthy; Larisa Broglie; Anita D'Souza; Shahinaz M. Gadalla; Robert Peter Gale; Shahrukh Hashmi; A. Samer Al-Homsi; Gerhard C. Hildebrandt; Peiman Hematti; David Rizzieri; Lynette Chee; Hillard M. Lazarus; Christopher Bredeson; Edgar A. Jaimes; Amer Beitinjaneh; Asad Bashey; Tim Prestidge; Maxwell M. Krem; David I. Marks; Stefanie Benoit; Jean A. Yared; Taiga Nishihori; Richard F. Olsson; Cesar O. Freytes; Edward Stadtmauer; Bipin N. Savani; Mohamed L. Sorror; Siddhartha Ganguly; John R. Wingard; Marcelo Pasquini

doi:10.1016/j.jtct.2021.02.030

Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation: N. Farhadfar et al

Nosha Farhadfar, Ajoy Dias, Tao Wang, Caitrin Fretham, Saurabh Chhabra, Hemant S. Murthy, Larisa Broglie, Anita D'Souza, Shahinaz M. Gadalla, Robert Peter Gale, Shahrukh Hashmi, A. Samer Al-Homsi, Gerhard C. Hildebrandt, Peiman Hematti, David Rizzieri, Lynette Chee, Hillard M. Lazarus, Christopher Bredeson, Edgar A. Jaimes, Amer BeitinjanehAsad Bashey, Tim Prestidge, Maxwell M. Krem, David I. Marks, Stefanie Benoit, Jean A. Yared, Taiga Nishihori, Richard F. Olsson, Cesar O. Freytes, Edward Stadtmauer, Bipin N. Savani, Mohamed L. Sorror, Siddhartha Ganguly, John R. Wingard, Marcelo Pasquini

Research output: Contribution to journal › Article › peer-review

20 Scopus citations

Abstract

Renal dysfunction is a recognized risk factor for mortality after allogeneic hematopoietic cell transplantation (alloHCT), yet our understanding of the effect of different levels of renal dysfunction at time of transplantation on outcomes remains limited. This study explores the impact of different degrees of renal dysfunction on HCT outcomes and examines whether the utilization of incremental degrees of renal dysfunction based on estimated glomerular filtration rate (eGFR) improve the predictability of the hematopoietic cell transplantation comorbidity index (HCT-CI). The study population included 2 cohorts: cohort 1, comprising patients age ≥40 years who underwent alloHCT for treatment of hematologic malignancies between 2008 and 2016 (n = 13,505; cohort selected given a very low incidence of renal dysfunction in individuals age <40 years), and cohort 2, comprising patients on dialysis at the time of HCT (n = 46). eGFR was measured using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method. The patients in cohort 1 were assigned into 4 categories—eGFR ≥90 mL/min (n = 7062), eGFR 60 to 89 mL/min (n = 5264), eGFR 45 to 59 mL/min (n = 897), and eGFR <45 mL/min (n=282)—to assess the impact of degree of renal dysfunction on transplantation outcomes. Transplantation outcomes in patients on dialysis at the time of alloHCT were analyzed separately. eGFR <60 mL/min was associated with an increased risk for nonrelapse mortality (NRM) and requirement for dialysis post-HCT. Compared with the eGFR ≥90 group, the hazard ratio (HR) for NRM was 1.46 (P = .0001) for the eGFR 45 to 59 mL/min group and 1.74 (P = .004) for the eGFR <45 mL/min group. Compared with the eGFR ≥90 mL/min group, the eGFR 45 to 59 mL/min group (HR, 2.45; P < .0001) and the eGFR <45 mL/min group (HR, 3.09; P < .0001) had a higher risk of renal failure necessitating dialysis after alloHCT. In addition, eGFR <45 mL/min was associated with an increased overall mortality (HR, 1.63; P < .0001). An eGFR-based revised HCT-CI was also developed and shown to be predictive of overall survival (OS) and NRM, with predictive performance similar to the original HCT-CI. Among 46 patients on dialysis at alloHCT, the 1-year probability of OS was 20%, and that of NRM was 67%. The degree of pretransplantation renal dysfunction is an independent predictor of OS, NRM, and probability of needing dialysis after alloHCT. An eGFR-based HCT-CI is a validated index for predicting outcomes in adults with hematologic malignancies undergoing alloHCT. The outcomes of alloHCT recipients on dialysis are dismal; therefore, one should strongly weigh the significant risks of being on hemodialysis as a factor in determining alloHCT candidacy.

Original language	English
Pages (from-to)	410-422
Number of pages	13
Journal	Transplantation and Cellular Therapy
Volume	27
Issue number	5
DOIs	https://doi.org/10.1016/j.jtct.2021.02.030
State	Published - May 2021

Bibliographical note

Publisher Copyright:
© 2021 The American Society for Transplantation and Cellular Therapy

Funding

Collaborators (other members of the Writing Committee): Allistair Abraham, Ibrahim Ahmed, Vaibhav Agrawal, Mahmoud Aljurf, Jeffrey J. Auletta, Nelli Bejanyan, Christopher Dandoy, Marcos de Lima, Miguel Angel Diaz, Natalie Callander, Jan Cerny, Gregory Guilcher, William Hogan, Benjamin Laskin, Parinda Mehta, Kasiani Myers, Sunita Nathan, Roomi Nusrat, Tracy O'Brien, Seth Rotz, Mitchell Sabloff, Insara Jaffer Sathick, Amir Steinberg, Sachiko Seo, John L. Wagner, and Basem M. William, Financial disclosure: The CIBMTR is supported primarily by Public Health Service U24CA076518 from the National Cancer Institute (NCI), the National Heart, Lung and Blood Institute (NHLBI) and the National Institute of Allergy and Infectious Diseases (NIAID); U24HL138660 from NHLBI and NCI; U01HL128568 from the NHLBI; HHSH250201700006C, and HHSH250201700007C from the Health Resources and Services Administration (HRSA); and N00014-18-1-2850, N00014-18-1-2888, and N00014-20-1-2705 from the Office of Naval Research. Additional federal support is provided by P01CA111412, R01CA152108, R01CA215134, R01CA218285, R01CA231141, R01AI128775, R01HL126589, R01HL129472, R01HL130388, R01HL131731, U01AI069197, U01AI126612, and BARDA. Support is also provided by Be the Match Foundation, Boston Children's Hospital, Dana Farber, St. Baldrick's Foundation, Stanford University, the Medical College of Wisconsin the National Marrow Donor Program, and from the following commercial entities: AbbVie; Actinium Pharmaceuticals, Inc.; Adaptive Biotechnologies; Adienne SA; Allovir, Inc.; Amgen Inc.; Angiocrine Bioscience; Astellas Pharma US; AstraZeneca; Atara Biotherapeutics, Inc.; bluebird bio, Inc.; Bristol Myers Squibb Co.; Celgene Corp.; CSL Behring; CytoSen Therapeutics, Inc.; Daiichi Sankyo Co. Ltd.; Gamida-Cell, Ltd.; Genentech Inc; HistoGenetics, Inc.; Incyte Corporation; Janssen Biotech, Inc.; Jazz Pharmaceuticals, Inc.; Johnson & Johnson; Kiadis Pharma; Kite, a Gilead Company; Kyowa Kirin; Legend Biotech; Magenta Therapeutics; Mallinckrodt LLC; Merck & Company, Inc.; Merck Sharp & Dohme Corp.; Millennium, the Takeda Oncology Co.; Miltenyi Biotec, Inc.; Novartis Pharmaceuticals Corporation; Omeros Corporation; Oncoimmune, Inc.; Orca Biosystems, Inc.; Pfizer, Inc.; Pharmacyclics, LLC; Sanofi Genzyme; Shire; Sobi, Inc.; Stemcyte; Takeda Pharma; Terumo BCT; Viracor Eurofins; Vor Bio Pharma; Xenikos BV; The views expressed in this article do not reflect the official policy or position of the National Institute of Health, the Department of the Navy, the Department of Defense, Health Resources and Services Administration (HRSA) or any other agency of the U.S. Government. CIBMTR supports accessibility of research in accord with the National Institutes of Health (NIH) Data Sharing Policy and the National Cancer Institute (NCI) Cancer Moonshot Public Access and Data Sharing Policy. The CIBMTR only releases de-identified datasets that comply with all relevant global regulations regarding privacy and confidentiality. Conflict of interest statement: Dr. Wingard reports personal fees from Ansun, personal fees from Shire, personal fees from Merck, personal fees from ReViral, personal fees from Celgene, personal fees from Janssen, personal fees from Cidara, outside the submitted work. Dr. Ganguly reports personal fees from Seattle Genetics, personal fees from KITE Pharma, personal fees from Kadmon, outside the submitted work. Dr. Hildebrandt reports other from Pfizer, other from Kite Pharma, other from Incyte, other from Jazz Pharmaceuticals, other from Alexion Pharmaceuticals, other from Karyopharm, other from Pharmacyclics, other from Takada, other from Jazz Pharmaceuticals, other from Kite Pharma, other from Incyte, other from Pfizer, other from Falk Foundation, other from Astellas Pharma, outside the submitted work. Dr. Nishihori reports other from Karyopharm, other from Novartis, outside the submitted work. Dr. Sorror reports personal fees from JAZZ pharmaceuticals, outside the submitted work. Dr. Wang reports grants from NIH, during the conduct of the study. Dr. Jaimes reports grants from National Institutes of Health, during the conduct of the study; other from Goldilocks Therapeutics Inc, outside the submitted work. Dr. Olsson reports personal fees from AstraZeneca, outside the submitted work. Dr. Rizzieri reports personal fees from Amgen, personal fees from Kite, personal fees from AROG, personal fees from Pharmacyclics, personal fees from Seattle Genetics, personal fees from Pfizer, personal fees from Novartis, personal fees from Sanofi-Aventis, personal fees from Incyte, personal fees from Gilead, personal fees from Jazz, from Abbvie, other from Celltron/Teva, other from Mustang, other from Bayer, other from Stemline, personal fees from Celgene, outside the submitted work. Dr. Hashmi reports COI not related to the manuscript include honoraria from Novartis. Pfizer, Mallinckrodt, Janssen for educational talks and meetings. Dr. Yared reports on time advisory board meeting paid fees from Gilead/Kite, and one-time advisory board meeting paid fees from Jazz, outside the submitted work. Financial disclosure: See Acknowledgments on page 421.

Funders	Funder number
Celltron/Teva
CytoSen Therapeutics, Inc.
Gilead Company
Goldilocks Therapeutics Inc
Incyte
Legend Biotech USA Incorporated
Magenta Therapeutics
Mallinckrodt LLC
Match Foundation
U.S. Government
National Institutes of Health (NIH)
U.S. Department of Defense
Office of Naval Research Naval Academy	P01CA111412, R01AI128775, R01CA231141, R01CA218285, U01AI069197, R01HL129472, U01AI126612, R01CA215134, R01HL130388, R01HL131731, R01HL126589, R01CA152108
Office of Naval Research Naval Academy
National Heart, Lung, and Blood Institute (NHLBI)
National Childhood Cancer Registry – National Cancer Institute	U24CA076518
National Childhood Cancer Registry – National Cancer Institute
National Institute of Allergy and Infectious Diseases	U24HL138660, HHSH250201700007C, U01HL128568
National Institute of Allergy and Infectious Diseases
Health Resources and Services Administration	N00014-20-1-2705, N00014-18-1-2850, N00014-18-1-2888
Health Resources and Services Administration
Falk Foundation
Pfizer
Astellas Pharma Inc.
Stanford University
Gilead Sciences
Janssen Biotech
Alexion Pharmaceuticals
AbbVie
Children's Hospital Boston
U.S. Public Health Service
CSL Behring GmbH
U.S. Navy Air Systems Command
Jazz Pharmaceuticals
Biomedical Advanced Research and Development Authority
Sanofi Genzyme
Kite Pharma Inc.
Bayer Fund
Kyowa Kirin Pharmaceutical Development
Daiichi Sankyo Company, Limited
Shire

Keywords

Allogeneic transplantation
Dialysis
HCT-CI
Renal dysfunction

ASJC Scopus subject areas

Immunology and Allergy
Molecular Medicine
Hematology
Cell Biology
Transplantation

Access to Document

10.1016/j.jtct.2021.02.030

Cite this

Farhadfar, N., Dias, A., Wang, T., Fretham, C., Chhabra, S., Murthy, H. S., Broglie, L., D'Souza, A., Gadalla, S. M., Gale, R. P., Hashmi, S., Al-Homsi, A. S., Hildebrandt, G. C., Hematti, P., Rizzieri, D., Chee, L., Lazarus, H. M., Bredeson, C., Jaimes, E. A., ... Pasquini, M. (2021). Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation: N. Farhadfar et al. Transplantation and Cellular Therapy, 27(5), 410-422. https://doi.org/10.1016/j.jtct.2021.02.030

@article{8cf203886ba74106af689995ca287b6a,

title = "Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation: N. Farhadfar et al",

abstract = "Renal dysfunction is a recognized risk factor for mortality after allogeneic hematopoietic cell transplantation (alloHCT), yet our understanding of the effect of different levels of renal dysfunction at time of transplantation on outcomes remains limited. This study explores the impact of different degrees of renal dysfunction on HCT outcomes and examines whether the utilization of incremental degrees of renal dysfunction based on estimated glomerular filtration rate (eGFR) improve the predictability of the hematopoietic cell transplantation comorbidity index (HCT-CI). The study population included 2 cohorts: cohort 1, comprising patients age ≥40 years who underwent alloHCT for treatment of hematologic malignancies between 2008 and 2016 (n = 13,505; cohort selected given a very low incidence of renal dysfunction in individuals age <40 years), and cohort 2, comprising patients on dialysis at the time of HCT (n = 46). eGFR was measured using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method. The patients in cohort 1 were assigned into 4 categories—eGFR ≥90 mL/min (n = 7062), eGFR 60 to 89 mL/min (n = 5264), eGFR 45 to 59 mL/min (n = 897), and eGFR <45 mL/min (n=282)—to assess the impact of degree of renal dysfunction on transplantation outcomes. Transplantation outcomes in patients on dialysis at the time of alloHCT were analyzed separately. eGFR <60 mL/min was associated with an increased risk for nonrelapse mortality (NRM) and requirement for dialysis post-HCT. Compared with the eGFR ≥90 group, the hazard ratio (HR) for NRM was 1.46 (P = .0001) for the eGFR 45 to 59 mL/min group and 1.74 (P = .004) for the eGFR <45 mL/min group. Compared with the eGFR ≥90 mL/min group, the eGFR 45 to 59 mL/min group (HR, 2.45; P < .0001) and the eGFR <45 mL/min group (HR, 3.09; P < .0001) had a higher risk of renal failure necessitating dialysis after alloHCT. In addition, eGFR <45 mL/min was associated with an increased overall mortality (HR, 1.63; P < .0001). An eGFR-based revised HCT-CI was also developed and shown to be predictive of overall survival (OS) and NRM, with predictive performance similar to the original HCT-CI. Among 46 patients on dialysis at alloHCT, the 1-year probability of OS was 20\%, and that of NRM was 67\%. The degree of pretransplantation renal dysfunction is an independent predictor of OS, NRM, and probability of needing dialysis after alloHCT. An eGFR-based HCT-CI is a validated index for predicting outcomes in adults with hematologic malignancies undergoing alloHCT. The outcomes of alloHCT recipients on dialysis are dismal; therefore, one should strongly weigh the significant risks of being on hemodialysis as a factor in determining alloHCT candidacy.",

keywords = "Allogeneic transplantation, Dialysis, HCT-CI, Renal dysfunction",

author = "Nosha Farhadfar and Ajoy Dias and Tao Wang and Caitrin Fretham and Saurabh Chhabra and Murthy, \{Hemant S.\} and Larisa Broglie and Anita D'Souza and Gadalla, \{Shahinaz M.\} and Gale, \{Robert Peter\} and Shahrukh Hashmi and Al-Homsi, \{A. Samer\} and Hildebrandt, \{Gerhard C.\} and Peiman Hematti and David Rizzieri and Lynette Chee and Lazarus, \{Hillard M.\} and Christopher Bredeson and Jaimes, \{Edgar A.\} and Amer Beitinjaneh and Asad Bashey and Tim Prestidge and Krem, \{Maxwell M.\} and Marks, \{David I.\} and Stefanie Benoit and Yared, \{Jean A.\} and Taiga Nishihori and Olsson, \{Richard F.\} and Freytes, \{Cesar O.\} and Edward Stadtmauer and Savani, \{Bipin N.\} and Sorror, \{Mohamed L.\} and Siddhartha Ganguly and Wingard, \{John R.\} and Marcelo Pasquini",

note = "Publisher Copyright: {\textcopyright} 2021 The American Society for Transplantation and Cellular Therapy",

year = "2021",

month = may,

doi = "10.1016/j.jtct.2021.02.030",

language = "English",

volume = "27",

pages = "410--422",

number = "5",

}

Farhadfar, N, Dias, A, Wang, T, Fretham, C, Chhabra, S, Murthy, HS, Broglie, L, D'Souza, A, Gadalla, SM, Gale, RP, Hashmi, S, Al-Homsi, AS, Hildebrandt, GC, Hematti, P, Rizzieri, D, Chee, L, Lazarus, HM, Bredeson, C, Jaimes, EA, Beitinjaneh, A, Bashey, A, Prestidge, T, Krem, MM, Marks, DI, Benoit, S, Yared, JA, Nishihori, T, Olsson, RF, Freytes, CO, Stadtmauer, E, Savani, BN, Sorror, ML, Ganguly, S, Wingard, JR & Pasquini, M 2021, 'Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation: N. Farhadfar et al', Transplantation and Cellular Therapy, vol. 27, no. 5, pp. 410-422. https://doi.org/10.1016/j.jtct.2021.02.030

TY - JOUR

T1 - Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation

T2 - N. Farhadfar et al

AU - Farhadfar, Nosha

AU - Dias, Ajoy

AU - Wang, Tao

AU - Fretham, Caitrin

AU - Chhabra, Saurabh

AU - Murthy, Hemant S.

AU - Broglie, Larisa

AU - D'Souza, Anita

AU - Gadalla, Shahinaz M.

AU - Gale, Robert Peter

AU - Hashmi, Shahrukh

AU - Al-Homsi, A. Samer

AU - Hildebrandt, Gerhard C.

AU - Hematti, Peiman

AU - Rizzieri, David

AU - Chee, Lynette

AU - Lazarus, Hillard M.

AU - Bredeson, Christopher

AU - Jaimes, Edgar A.

AU - Beitinjaneh, Amer

AU - Bashey, Asad

AU - Prestidge, Tim

AU - Krem, Maxwell M.

AU - Marks, David I.

AU - Benoit, Stefanie

AU - Yared, Jean A.

AU - Nishihori, Taiga

AU - Olsson, Richard F.

AU - Freytes, Cesar O.

AU - Stadtmauer, Edward

AU - Savani, Bipin N.

AU - Sorror, Mohamed L.

AU - Ganguly, Siddhartha

AU - Wingard, John R.

AU - Pasquini, Marcelo

PY - 2021/5

Y1 - 2021/5

N2 - Renal dysfunction is a recognized risk factor for mortality after allogeneic hematopoietic cell transplantation (alloHCT), yet our understanding of the effect of different levels of renal dysfunction at time of transplantation on outcomes remains limited. This study explores the impact of different degrees of renal dysfunction on HCT outcomes and examines whether the utilization of incremental degrees of renal dysfunction based on estimated glomerular filtration rate (eGFR) improve the predictability of the hematopoietic cell transplantation comorbidity index (HCT-CI). The study population included 2 cohorts: cohort 1, comprising patients age ≥40 years who underwent alloHCT for treatment of hematologic malignancies between 2008 and 2016 (n = 13,505; cohort selected given a very low incidence of renal dysfunction in individuals age <40 years), and cohort 2, comprising patients on dialysis at the time of HCT (n = 46). eGFR was measured using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method. The patients in cohort 1 were assigned into 4 categories—eGFR ≥90 mL/min (n = 7062), eGFR 60 to 89 mL/min (n = 5264), eGFR 45 to 59 mL/min (n = 897), and eGFR <45 mL/min (n=282)—to assess the impact of degree of renal dysfunction on transplantation outcomes. Transplantation outcomes in patients on dialysis at the time of alloHCT were analyzed separately. eGFR <60 mL/min was associated with an increased risk for nonrelapse mortality (NRM) and requirement for dialysis post-HCT. Compared with the eGFR ≥90 group, the hazard ratio (HR) for NRM was 1.46 (P = .0001) for the eGFR 45 to 59 mL/min group and 1.74 (P = .004) for the eGFR <45 mL/min group. Compared with the eGFR ≥90 mL/min group, the eGFR 45 to 59 mL/min group (HR, 2.45; P < .0001) and the eGFR <45 mL/min group (HR, 3.09; P < .0001) had a higher risk of renal failure necessitating dialysis after alloHCT. In addition, eGFR <45 mL/min was associated with an increased overall mortality (HR, 1.63; P < .0001). An eGFR-based revised HCT-CI was also developed and shown to be predictive of overall survival (OS) and NRM, with predictive performance similar to the original HCT-CI. Among 46 patients on dialysis at alloHCT, the 1-year probability of OS was 20%, and that of NRM was 67%. The degree of pretransplantation renal dysfunction is an independent predictor of OS, NRM, and probability of needing dialysis after alloHCT. An eGFR-based HCT-CI is a validated index for predicting outcomes in adults with hematologic malignancies undergoing alloHCT. The outcomes of alloHCT recipients on dialysis are dismal; therefore, one should strongly weigh the significant risks of being on hemodialysis as a factor in determining alloHCT candidacy.

AB - Renal dysfunction is a recognized risk factor for mortality after allogeneic hematopoietic cell transplantation (alloHCT), yet our understanding of the effect of different levels of renal dysfunction at time of transplantation on outcomes remains limited. This study explores the impact of different degrees of renal dysfunction on HCT outcomes and examines whether the utilization of incremental degrees of renal dysfunction based on estimated glomerular filtration rate (eGFR) improve the predictability of the hematopoietic cell transplantation comorbidity index (HCT-CI). The study population included 2 cohorts: cohort 1, comprising patients age ≥40 years who underwent alloHCT for treatment of hematologic malignancies between 2008 and 2016 (n = 13,505; cohort selected given a very low incidence of renal dysfunction in individuals age <40 years), and cohort 2, comprising patients on dialysis at the time of HCT (n = 46). eGFR was measured using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) method. The patients in cohort 1 were assigned into 4 categories—eGFR ≥90 mL/min (n = 7062), eGFR 60 to 89 mL/min (n = 5264), eGFR 45 to 59 mL/min (n = 897), and eGFR <45 mL/min (n=282)—to assess the impact of degree of renal dysfunction on transplantation outcomes. Transplantation outcomes in patients on dialysis at the time of alloHCT were analyzed separately. eGFR <60 mL/min was associated with an increased risk for nonrelapse mortality (NRM) and requirement for dialysis post-HCT. Compared with the eGFR ≥90 group, the hazard ratio (HR) for NRM was 1.46 (P = .0001) for the eGFR 45 to 59 mL/min group and 1.74 (P = .004) for the eGFR <45 mL/min group. Compared with the eGFR ≥90 mL/min group, the eGFR 45 to 59 mL/min group (HR, 2.45; P < .0001) and the eGFR <45 mL/min group (HR, 3.09; P < .0001) had a higher risk of renal failure necessitating dialysis after alloHCT. In addition, eGFR <45 mL/min was associated with an increased overall mortality (HR, 1.63; P < .0001). An eGFR-based revised HCT-CI was also developed and shown to be predictive of overall survival (OS) and NRM, with predictive performance similar to the original HCT-CI. Among 46 patients on dialysis at alloHCT, the 1-year probability of OS was 20%, and that of NRM was 67%. The degree of pretransplantation renal dysfunction is an independent predictor of OS, NRM, and probability of needing dialysis after alloHCT. An eGFR-based HCT-CI is a validated index for predicting outcomes in adults with hematologic malignancies undergoing alloHCT. The outcomes of alloHCT recipients on dialysis are dismal; therefore, one should strongly weigh the significant risks of being on hemodialysis as a factor in determining alloHCT candidacy.

KW - Allogeneic transplantation

KW - Dialysis

KW - HCT-CI

KW - Renal dysfunction

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UR - http://www.scopus.com/inward/citedby.url?scp=85103656481&partnerID=8YFLogxK

U2 - 10.1016/j.jtct.2021.02.030

DO - 10.1016/j.jtct.2021.02.030

M3 - Article

C2 - 33775617

AN - SCOPUS:85103656481

SN - 2666-6367

VL - 27

SP - 410

EP - 422

JO - Transplantation and Cellular Therapy

JF - Transplantation and Cellular Therapy

IS - 5

ER -

Impact of Pretransplantation Renal Dysfunction on Outcomes after Allogeneic Hematopoietic Cell Transplantation: N. Farhadfar et al

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