Hematopoietic Cell Transplant Comorbidity Index (Hct-Ci) To Assess Aml Induction Risk.

e18519 Background: Induction therapy for acute myeloid leukemia (AML) is intense and methods for risk appraisal of therapy are controversial. Formal comorbidity assessment may allow for improved prognostication in addition to age. The HCT-CI(+/-Age) was developed to inform risk of patients undergoing stem cell transplant, and has found use in predicting early outcomes in AML induction. We applied HCT-CI retrospectively to our experience to analyze the predictive power regarding patient survival during induction. Methods: 140 cases induced with idarubicin and cytarabine (IA) or IA plus cladribine (IAC) between Jan 2008 and Sept 2015. HCT-CI (+/- Age) was derived from information available prior to chemotherapy and NCCN Leukemia Risk were calculated. Death prior to discharge from the initial induction hospitalization was the primary outcome for logistic regression. Results: 107 patients received IAC and 33 IA with mean age of 57 and 66 years respectively (p<0.01). Regimen did not predict death (p=0.27). Median age was 61 (range 20-86) with mean scores of 2.0±0.2 (HCT-CI) and 2.9±0.2 (HCT-CI+Age). In univariate analysis HCT-CI (+/-Age) predicted death during induction. In multivariate analyses, when HCT-CI (+/-Age) was adjusted for (NCCN risk and regimen) or (age and regimen) predictive power was maintained (Table). Conclusions: These data suggest that HCT-CI predicts death during induction of AML and age did not augment prediction, up to age 70. We conclude that HCT-CI(+/-Age) may be a more useful tool than age alone or clinical instinct to help patients and providers make difficult decisions about therapy. [Table: see text]