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Hematopoietic Cell Transplantation Frailty Scale (HCT-FS): Prognostic utility in adult candidates for allo-HSCT
Assessment of patient frailty prior to allogeneic hematopoietic stem cell transplantation (allo-HSCT) is increasingly recognized as a predictor of post-transplant outcomes.1 The Hematopoietic Cell Transplantation Frailty Scale (HCT-FS) was implemented in routine clinical practice across 16 allo-HSCT programs in Canada and Spain.1 During the European Hematology Association (EHA) 2025 Congress, Maria Queralt Salas presented results from a prospective study of data at these centers, evaluating the prognostic utility of the HCT-FS for stratifying adult allo-HSCT candidates into fit, pre-frail, and frail categories, and aiming to validate frailty as a predictor of transplant outcomes.1
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Key learnings |
Two-year OS differed significantly by HCT-FS category (fit, 82%; pre-frail, 73%; frail, 62%), validating frailty as a prognostic indicator of post-transplant survival. |
Significant differences were also observed in 2-year NRM (fit, 12%; pre-frail, 20%; frail, 32%; p < 0.001), indicating frailty as a key driver of NRM post-allo-HSCT. |
Frailty was associated with poorer clinical outcomes, including prolonged hospitalization (p = 0.003), increased readmissions (p = 0.016), 1-year invasive fungal infection risk (p = 0.004), and increased cumulative incidence of ICU admission at Day >180 (p = 0.002). |
The HCT-FS provided reliable stratification of frailty status in adult candidates for allo-HSCT, with results confirming frailty as a predictor of post-transplant outcomes. |
Abbreviations: allo-HSCT, allogeneic hematopoietic stem cell transplantation; EHA, European Hematology Association; HCT-FS, Hematopoietic Cell Transplantation Frailty Scale; ICU, intensive care unit; NRM, non-relapse mortality; OS, overall survival.
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