Prospective implementation of the HCT frailty scale in adults with lymphoproliferative syndromes candidates for autologous haematopoietic stem cell transplantation: Results from a multicentre GETH-TC study

Br J Haematol. 2026 Apr 29. doi: 10.1111/bjh.70505. Online ahead of print.

ABSTRACT

This prospective study evaluated the incidence and dynamics of frailty in 156 adults with lymphoproliferative syndromes undergoing autologous haematopoietic stem cell transplantation (HSCT). Frailty was assessed using the haematopoietic cell transplantation (HCT) frailty scale in patients from 15 Spanish institutions at initial consultation, transplant admission and day +100. Quality of life (QoL) was measured using the EuroQoL. At first consultation, 45 patients (28.8%) were classified as fit, 93 (59.6%) as pre-frail and 18 (11.6%) as frail. Frailty was more frequent among older patients, those with Karnofsky performance status (KPS) below 90%, and abnormal Mini-Cog scores (<3). Rates of relapse, death, readmission and median hospital stay were similar across frailty groups. However, frail patients reported significantly worse QoL. One-year non-relapse mortality was higher in frail patients than in pre-frail and fit patients, although differences were not statistically significant (p = 0.19). At day +100, 33.6% of patients were fit, 57.9% pre-frail and 8.5% frail, demonstrating significant transitions in frailty over time (p = 0.001). Moreover, frail patients showed lower relapse-free [53.3% (17.7-79.6) vs. 85.3% (68.3-93.6), p = 0.05] and overall survival [77.8% (36.5-93.9) vs. 100%, p = 0.16], and worse perceived QoL than fit ones. Overall, frailty was dynamic and clinically relevant, supporting routine assessment and targeted interventions to mitigate adverse outcomes.

PMID:42056024 | DOI:10.1111/bjh.70505