Models investigated in recipients of allogeneic HCT and the required information per model with an accompanying link to an online calculator or mobile application whenever available
| HCT-CI comorbidities . | PAM . | Modified PAM . | Modified EBMT . | HCT-CI/EBMT . | R-DRI∗ . | NRM-J . | The SCI . | TRM . | AML-composite model (AML-CM) . | HCT-CR . | EASIX . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Arrhythmia | Age (y) | Age: ≥65 | Age: <20, 20-40, and >40 | HCT-CI = 0 and EBMT score = 0-3 | Low | Age: 50-59 and ≥60 | Age: ≥60 | Age (y) | Age: 50-59 and ≥60 | HCT-CI/Age model | Creatinine |
| Cardiac | Donor type | Donor type | Disease status: CR1, CR >1, and no CR | HCT-CI = 0 and EBMT score = 4-7 | Intermediate | Sex: male | Composite cardiac: arrhythmia, cardiac, and heart valve disease | Performance status | All HCT-CI comorbidities | Revised DRI | LDH |
| Inflammatory bowel disease | Disease risk† | Disease risk‡ | Donor: MRD vs others | HCT-CI = 1-2 and EBMT score = 0-3 | High | Performance status: 1 and ≥2 | Hepatic—moderate/severe | White blood cell count | LDH (>200-1000 and >1000) | Platelet count | |
| Diabetes | Conditioning§ | FEV1|| | Donor⁄ recipient sex: female, male, or others | HCT-CI = 0 and EBMT score = 4-7 | Very high | HCT-CI: ≥3 | Pulmonary—moderate | Peripheral blood blast percentage | Albumin (<3.5) | — | — |
| Cerebrovascular | FEV1: >80%, 70%-80%, <70% | Patient/donor CMV: –/–, –/+, +/−, +/+ | HCT-CI = ≥3 and EBMT score = 0-3 | — | Donor: unrelated BM, related PB, cord blood | Pulmonary—severe | Type of AML [de novo vs secondary] | 2017 ELN cytomolecular risks (favorable, intermediate, adverse | — | — | |
| Psychiatric | DLco: >80%, 70%-80%, <70% | — | — | HCT-CI = ≥3 and EBMT score = 4-7 | — | — | Renal dysfunction per EGFR¶ | Platelet count | — | — | — |
| Hepatic—mild | Serum creatinine: >106 μmol/L (>1.2 mg/dL) | — | — | — | — | — | — | Albumin | — | — | — |
| Obesity | ALT: >22 μmol/L (>1.3 mg/dL) | — | — | — | — | — | — | Creatinine | — | — | — |
| Infection | — | — | — | — | — | — | — | — | — | — | — |
| Rheumatologic | — | — | — | — | — | — | — | — | — | — | — |
| Peptic ulcer | — | — | — | — | — | — | — | — | — | — | — |
| Renal—moderate/severe | — | — | — | — | — | — | — | — | — | — | — |
| Pulmonary—moderate | — | — | — | — | — | — | — | — | — | — | — |
| Prior malignancy | — | — | — | — | — | — | — | — | — | — | — |
| Heart valve disease | — | — | — | — | — | — | — | — | — | — | — |
| Pulmonary—severe | — | — | — | — | — | — | — | — | — | — | — |
| Hepatic—moderate/severe | — | — | — | — | — | — | — | — | — | — | — |
| HCT-CI comorbidities . | PAM . | Modified PAM . | Modified EBMT . | HCT-CI/EBMT . | R-DRI∗ . | NRM-J . | The SCI . | TRM . | AML-composite model (AML-CM) . | HCT-CR . | EASIX . |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Arrhythmia | Age (y) | Age: ≥65 | Age: <20, 20-40, and >40 | HCT-CI = 0 and EBMT score = 0-3 | Low | Age: 50-59 and ≥60 | Age: ≥60 | Age (y) | Age: 50-59 and ≥60 | HCT-CI/Age model | Creatinine |
| Cardiac | Donor type | Donor type | Disease status: CR1, CR >1, and no CR | HCT-CI = 0 and EBMT score = 4-7 | Intermediate | Sex: male | Composite cardiac: arrhythmia, cardiac, and heart valve disease | Performance status | All HCT-CI comorbidities | Revised DRI | LDH |
| Inflammatory bowel disease | Disease risk† | Disease risk‡ | Donor: MRD vs others | HCT-CI = 1-2 and EBMT score = 0-3 | High | Performance status: 1 and ≥2 | Hepatic—moderate/severe | White blood cell count | LDH (>200-1000 and >1000) | Platelet count | |
| Diabetes | Conditioning§ | FEV1|| | Donor⁄ recipient sex: female, male, or others | HCT-CI = 0 and EBMT score = 4-7 | Very high | HCT-CI: ≥3 | Pulmonary—moderate | Peripheral blood blast percentage | Albumin (<3.5) | — | — |
| Cerebrovascular | FEV1: >80%, 70%-80%, <70% | Patient/donor CMV: –/–, –/+, +/−, +/+ | HCT-CI = ≥3 and EBMT score = 0-3 | — | Donor: unrelated BM, related PB, cord blood | Pulmonary—severe | Type of AML [de novo vs secondary] | 2017 ELN cytomolecular risks (favorable, intermediate, adverse | — | — | |
| Psychiatric | DLco: >80%, 70%-80%, <70% | — | — | HCT-CI = ≥3 and EBMT score = 4-7 | — | — | Renal dysfunction per EGFR¶ | Platelet count | — | — | — |
| Hepatic—mild | Serum creatinine: >106 μmol/L (>1.2 mg/dL) | — | — | — | — | — | — | Albumin | — | — | — |
| Obesity | ALT: >22 μmol/L (>1.3 mg/dL) | — | — | — | — | — | — | Creatinine | — | — | — |
| Infection | — | — | — | — | — | — | — | — | — | — | — |
| Rheumatologic | — | — | — | — | — | — | — | — | — | — | — |
| Peptic ulcer | — | — | — | — | — | — | — | — | — | — | — |
| Renal—moderate/severe | — | — | — | — | — | — | — | — | — | — | — |
| Pulmonary—moderate | — | — | — | — | — | — | — | — | — | — | — |
| Prior malignancy | — | — | — | — | — | — | — | — | — | — | — |
| Heart valve disease | — | — | — | — | — | — | — | — | — | — | — |
| Pulmonary—severe | — | — | — | — | — | — | — | — | — | — | — |
| Hepatic—moderate/severe | — | — | — | — | — | — | — | — | — | — | — |
Online calculators: HCT-CI (http://hctci.org/Home/Calculator or http://tgapp.asbmt.org/); PAM (not available); The modified EBMT (not available); R-DRI (https://cibmtr.org/CIBMTR/Resources/Research-Tools-Calculators/Disease-Risk-Index-DRI-Assignment-Tool or http://tgapp.asbmt.org/); NRM-J (not available); The SCI (http://tgapp.asbmt.org/); TRM (https://trmcalculator.fredhutch.org/); AML-CM (http://amlcompositemodel.org/Home/GetCalculator); and EASIX (https://biostatistics.dkfz.de/EASIX/).
ALT, alanine transaminase; CMV, cytomegalovirus; EASIX, Endothelial Activation and Stress Index; ELN-2022, European Leukemia Network Classification 2022; LDH, lactate dehydrogenase.
Disease status: low: Hodgkin lymphoma (HL) in complete remission (CR), chronic lymphocytic leukemia (CLL) in CR or partial remission (PR), mantle cell lymphoma CR, indolent lymphoma CR or PR, acute myeloid leukemia (AML) favorable cytogenetics CR, chronic myeloid leukemia (CML) chronic phase 1 or 2; intermediate: CML advanced phase, mantle cell lymphoma PR, myeloproliferative disease, AML intermediate cytogenetics CR, acute lymphoblastic leukemia (ALL) CR1, T-cell NHL CR/PR, multiple myeloma (MM) CR/very good partial remission (VGPR)/PR, aggressive non-Hodgkin lymphoma (NHL) CR, low-risk myelodysplastic syndromes (MDS) intermediate cytogenetics (early/advanced), low-risk MDS adverse cytogenetics (early), advanced indolent NHL, advanced CLL, aggressive NHL PR; high: advanced T-cell NHL, advanced AML favorable cytogenetics, advanced HL, advanced high-risk MDS intermediate cytogenetics, early/advanced high-risk MDS adverse cytogenetics, ALL CR2/CR3, AML adverse cytogenetics CR, advanced mantle cell lymphoma, Burkitt lymphoma CR, advanced MM, advanced low-risk MDS adverse cytogenetics, advanced AML intermediate cytogenetics; very high-risk: CML blast phase, advanced ALL, advanced aggressive NHL, advanced AML adverse cytogenetics, advanced Burkitt lymphoma (BL) in PR.
Disease risks include low-risk diseases included chronic myelogenous leukemia in chronic phase, refractory anemia, aplastic anemia, and the Blackfan-Diamond syndrome. Intermediate-risk diseases included chronic myelogenous leukemia in accelerated or phase after blastic phase, acute leukemia or lymphoma in remission, refractory anemia with excess blasts, chronic lymphocytic leukemia, and paroxysmal nocturnal hemoglobinuria. High-risk diseases included chronic myelogenous leukemia in blastic phase, juvenile chronic myelogenous leukemia, acute leukemia or lymphoma in relapse, refractory anemia with excess blasts in transformation, and myeloma. Solid tumors and nonhematologic diseases were also classified as high-risk diseases.
Overall-risk groups were determined based on the risk index developed by Armand et al, which includes disease risk, stage risk, and cytogenetic data for AML and MDS. The poor and very poor MDS cytogenetic risk categories defined by Deeg et al33 were grouped as high-risk disease, and all other categories were grouped as intermediate-risk disease.
Myeloablative regimens were categorized based on the dose of total-body irradiation used (12 Gy or 12 Gy). All patients in the nonmyeloablative group received 2 Gy of total-body irradiation.
The relative change in hazard ratio for each decrease in FEV1 by 10%.
Based on estimated glomerular filtration rate (eGFR) mL/min per 1.73 m2, using the chronic kidney disease epidemiology collaboration (CKD-EPI) formula for estimating creatinine clearance. An eGFR of ≥90 mL/min per 1.73 m2 was considered normal, from 60 to 89.9 mL/min per 1.73 m2 was considered to be mildly decreased, and <60 mL/min per 1.73 m2 as moderately to severely decreased.