The Simplified Comorbidity Index predicts non-relapse mortality in reduced-intensity conditioning allogeneic haematopoietic cell transplantation

Shlomo Elias, Samantha Brown, Sean M. Devlin, Juliet N. Barker, Christina Cho, David J. Chung, Parastoo B. Dahi, Sergio Giralt, Boglarka Gyurkocza, Ann A. Jakubowski, Oscar B. Lahoud, Heather Landau, Richard J. Lin, Esperanza B. Papadopoulos, Ioannis Politikos, Doris M. Ponce, Michael Scordo, Brian C. Shaffer, Gunjan L. Shah, Roni TamariJames W. Young, Miguel Angel Perales, Roni Shouval

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Comorbidity assessment before allogeneic haematopoietic cell transplantation (allo-HCT) is essential for estimating non-relapse mortality (NRM) risk. We previously developed the Simplified Comorbidity Index (SCI), which captures a small number of ‘high-yield’ comorbidities and older age. The SCI was predictive of NRM in myeloablative CD34-selected allo-HCT. Here, we evaluated the SCI in a single-centre cohort of 327 patients receiving reduced-intensity conditioning followed by unmanipulated allografts from HLA-matched donors. Among the SCI factors, age above 60, mild renal impairment, moderate pulmonary disease and cardiac disease were most frequent. SCI scores ranged from 0 to 8, with 39%, 20%, 20% and 21% having scores of 0–1, 2, 3 and ≥4 respectively. Corresponding cumulative incidences of 3-year NRM were 11%, 16%, 22% and 27%; p = 0.03. In multivariable models, higher SCI scores were associated with incremental risks of all-cause mortality and NRM. The SCI had an area under the receiver operating characteristic curve of 65.9%, 64.1% and 62.9% for predicting 1-, 2- and 3-year NRM versus 58.4%, 60.4% and 59.3% with the haematopoietic cell transplantation comorbidity index. These results demonstrate for the first time that the SCI is predictive of NRM in patients receiving allo-HCT from HLA-matched donors after reduced-intensity conditioning.

Original languageEnglish
Pages (from-to)840-851
Number of pages12
JournalBritish Journal of Haematology
Issue number5
Early online date24 Aug 2023
StatePublished - Dec 2023
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2023 British Society for Haematology and John Wiley & Sons Ltd.


The research was supported in part by the Memorial Sloan Kettering Cancer Center Core grant (P30 CA008748) from the National Institutes of Health/National Cancer Institute. RS was supported by the American Society of Transplantation and Cellular Therapy New Investigator Award, the American Society of Hematology Fellow Scholar Award, a grant from the Long Island Sound Chapter, Swim Across America, the Robert Hirschhorn Award, the Memorial Sloan Kettering Steven Greenberg Lymphoma Research and the Lymphoma Research Foundation Career Development Award. SE is supported by the American Society of Hematology Global Research Award and by Hadassah “OFEK” research award. The graphical abstract was created with .

FundersFunder number
Long Island Sound Chapter
National Institutes of Health
National Cancer Institute
American Society of Hematology
American Society for Transplantation and Cellular Therapy
Swim Across America


    • Simplified Comorbidity Index
    • allogeneic haematopoietic cell transplantation
    • comorbidity
    • non-relapse mortality


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