HCT ‐ FS ‐Defined Frailty Is Associated With Lower Survival Across Diverse Hematologic Diagnoses After Allogeneic Transplantation

OBJECTIVES: To evaluate whether Hematopoietic Cell Transplantation Frailty Scale (HCT-FS)-defined frailty predicts overall survival (OS), nonrelapse mortality (NRM), and relapse across diverse hematologic diagnoses undergoing allogeneic hematopoietic cell transplantation (alloHCT), including nonmalignant disorders. METHODS: We conducted a multicenter retrospective cohort study of 992 adults undergoing alloHCT at 16 centers in Canada and Spain (2018-2023). Frailty was assessed at consultation using the HCT-FS (fit, prefrail, frail). OS was estimated by Kaplan-Meier, competing-risks methods by cumulative incidence. Multivariable models assessed associations with OS and NRM. RESULTS: Frailty was assessed across six diagnostic categories, including nonmalignant disorders (4.8%). At consultation, 32.1% were fit, 54.7% prefrail, and 13.2% frail. Increasing frailty was associated with progressively lower 2-year OS (78.9%, 66.0%, 51.7%; p < 0.001) and higher 2-year NRM (10.5%, 18.9%, 33.2%; p < 0.001; HR 1.77 [95% CI 1.21-2.60] prefrail and 3.65 [2.36-5.65] frail vs. fit), while 2-year relapse incidence did not differ (19.0%, 23.5%, 22.3%; p = 0.229). Disease-specific estimates were exploratory and limited by small subgroup sizes. CONCLUSIONS: HCT-FS-defined frailty is associated with OS and NRM but not relapse in this multicenter alloHCT cohort. Larger disease-specific studies are needed to establish its prognostic value in less represented indications.

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Journal
European Journal Of Haematology
Published
2026-10-28
DOI
https://doi.org/10.1111/ejh.70344
Primary Topic
Hematopoietic Stem Cell Transplantation
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article
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article

HCT ‐ FS ‐Defined Frailty Is Associated With Lower Survival Across Diverse Hematologic Diagnoses After Allogeneic Transplantation

Leyre Bento, Javier Cornago, Sara Villar, María Queralt Salas et al.
5 links
European Journal Of Haematology
Hematopoietic Stem Cell Transplantation
article

HCT ‐ FS ‐Defined Frailty Is Associated With Lower Survival Across Diverse Hematologic Diagnoses After Allogeneic Transplantation

Leyre Bento, Javier Cornago, Sara Villar, María Queralt Salas, Ana Santamaria, Rajat Kumar, María Laura Fox, Sara Fernández‐Luis, Albert Esquirol, Igor Novitzky‐Basso, Eshrak Al‐Shaibani, Alberto Mussetti, Joaquina M. Salmerón Camacho, Tommy Alfaro Moya, Ivan Pašić, Auro Viswabandya, Fotios V. Michelis, Anna Maria Sureda, Laura Pardo Gambarte, Jonas Mattsson, Andrés Sánchez‐Salinas, Dennis Dong Hwan Kim, Pascual Balsalobre, Javier López-Marín, Marina Acera Gómez, Silvia Filaferro, Zahra Abdallahi‐Lefdil, Mónica Baile González, María del Carmen Quintela González, María del Mar Pérez Artigas, Isabel Izquierdo, Montserrat Rovira, S. M. Alibhai, Verónica Illana Álvaro, Leddy Patricia Vega Suárez, Patricia Beorlegui Murillo, Esperanza Lavilla
article en

Abstract

OBJECTIVES: To evaluate whether Hematopoietic Cell Transplantation Frailty Scale (HCT-FS)-defined frailty predicts overall survival (OS), nonrelapse mortality (NRM), and relapse across diverse hematologic diagnoses undergoing allogeneic hematopoietic cell transplantation (alloHCT), including nonmalignant disorders. METHODS: We conducted a multicenter retrospective cohort study of 992 adults undergoing alloHCT at 16 centers in Canada and Spain (2018-2023). Frailty was assessed at consultation using the HCT-FS (fit, prefrail, frail). OS was estimated by Kaplan-Meier, competing-risks methods by cumulative incidence. Multivariable models assessed associations with OS and NRM. RESULTS: Frailty was assessed across six diagnostic categories, including nonmalignant disorders (4.8%). At consultation, 32.1% were fit, 54.7% prefrail, and 13.2% frail. Increasing frailty was associated with progressively lower 2-year OS (78.9%, 66.0%, 51.7%; p < 0.001) and higher 2-year NRM (10.5%, 18.9%, 33.2%; p < 0.001; HR 1.77 [95% CI 1.21-2.60] prefrail and 3.65 [2.36-5.65] frail vs. fit), while 2-year relapse incidence did not differ (19.0%, 23.5%, 22.3%; p = 0.229). Disease-specific estimates were exploratory and limited by small subgroup sizes. CONCLUSIONS: HCT-FS-defined frailty is associated with OS and NRM but not relapse in this multicenter alloHCT cohort. Larger disease-specific studies are needed to establish its prognostic value in less represented indications.

European Journal Of Haematology
Hospital de Sant Pau (ES), Princess Margaret Cancer Centre (CA), Grupo Español de Trasplante Hematopoyético y Terapia Celular (ES), Complejo Hospitalario de Salamanca (ES), Marqués de Valdecilla University Hospital (ES), Institut Català d'Oncologia (ES), Hospital Universitario Miguel Servet (ES), Hospital Clínic de Barcelona (ES), Vall d'Hebron Hospital Universitari (ES), Hospital Universitario Fundación Jiménez Díaz (ES), Hospital Universitario de La Princesa (ES), Instituto de Investigación Biomédica de Salamanca (ES), Clinica Universidad de Navarra (ES), Hospital General Universitario de Alicante Doctor Balmis (ES), Duran i Reynals Hospital (ES), Hospital Universitario Lucus Augusti (ES), Instituto Murciano de Investigación Biosanitaria (ES), Hospital Universitario Virgen de la Arrixaca (ES), Hospital Universitario Son Espases (ES)
Good health and well-being
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Hematopoietic Stem Cell Transplantation
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