Abstract
Systemic inflammatory response (SIR) measures are known prognostic values in patients with solid tumours. Little is known about their impact in haematological diseases or allogeneic haematopoietic cell transplantation (alloHCT). Therefore, we evaluate the association of pretransplant inflammatory markers with the clinical outcome in a prospective analysis of alloHCT. We included 2201 consecutive patients undergoing their first alloHCT. At admission, C-reactive protein (CRP), serum albumin (sALB), a composite inflammatory score (modified Glasgow prognostic score, mGPS) and the body mass index (BMI) were recorded. These, the EBMT score and the HCT-specific comorbidity index (HCT-CI) were statistically analysed for overall/progression-free survival (OS/PFS), non-relapse mortality (NRM), relapse and graft-versus-host disease (GvHD). CRP was increased in 34.8%, 17% had a low sALB, 2.9% an increased (≥35 kg/m(2)) and 3% a very low BMI (<18.5 kg/m(2)). For mGPS, we observed score 1 (24%) and 2 (11%). A multivariable model explored mGPS 1 (SHR 1.301) and mGPS 2 (SHR 1.915) as significant risk factors (p < 0.001) for OS and for PFS (mGPS 1 (SHR 1.202); mGPS 2 (SHR 1.765)). Only mGPS 2 (HR 1.671; p < 0.001) revealed influence on NRM. Pretransplant SIR markers and their combination (mGPS) displayed a highly significant association with clinical outcome, possibly enriching present alloHCT risk scores.