Characteristics of adult patients who received first allo-HCT for AML, ALL, or MDS between 2008 and 2018 in the United States and developed aGVHD, by race/ethnicity (n = 6259)
| Characteristic . | Non-Hispanic White . | Non-Hispanic Black . | Hispanic . | Asian . | P value . |
|---|---|---|---|---|---|
| No. of patients | 5015 | 403 | 564 | 277 | |
| No. of centers | 131 | 83 | 91 | 70 | |
| Age at HCT, y | <.01 | ||||
| Median (min-max) | 58.8 (18-83) | 48.7 (18-75) | 44.9 (18-74) | 49 (18-74) | |
| 18-29 | 352 (7) | 66 (16) | 149 (26) | 46 (17) | |
| 30-39 | 374 (7) | 67 (17) | 102 (18) | 49 (18) | |
| 40-49 | 648 (13) | 81 (20) | 87 (15) | 50 (18) | |
| 50-59 | 1332 (27) | 97 (24) | 111 (20) | 62 (22) | |
| 60-69 | 1844 (37) | 80 (20) | 100 (18) | 56 (20) | |
| ≥70 | 465 (9) | 12 (3) | 15 (3) | 14 (5) | |
| Recipient sex | |||||
| Male | 2902 (58) | 188 (47) | 309 (55) | 140 (51) | |
| Female | 2113 (42) | 215 (53) | 255 (45) | 137 (49) | |
| Karnofsky score | <.01 | ||||
| <90 | 2152 (43) | 187 (46) | 202 (36) | 109 (39) | |
| ≥90 | 2801 (56) | 210 (52) | 351 (62) | 162 (58) | |
| Missing | 62 (1) | 6 (1) | 11 (2) | 6 (2) | |
| HCT-CI | <.01 | ||||
| 0 | 1013 (20) | 80 (20) | 172 (30) | 75 (27) | |
| 1-2 | 1429 (28) | 122 (30) | 173 (31) | 74 (27) | |
| 3+ | 2545 (51) | 200 (50) | 218 (39) | 127 (46) | |
| Missing | 28 (1) | 1 (0) | 1 (0) | 1 (0) | |
| Median household income by ZIP code | <.01 | ||||
| <$48 000 | 1150 (23) | 167 (41) | 221 (39) | 24 (9) | |
| $48 000-$60 999 | 1216 (24) | 106 (26) | 131 (23) | 47 (17) | |
| $61 000-$79 999 | 1346 (27) | 69 (17) | 133 (24) | 73 (26) | |
| ≥$80 000 | 1249 (25) | 57 (14) | 64 (11) | 129 (47) | |
| Missing | 54 (1) | 4 (1) | 15 (3) | 4 (1) | |
| Health insurance type | <.01 | ||||
| No insurance | 25 (0) | 4 (1) | 16 (3) | 5 (2) | |
| Disability insurance ± others | 96 (2) | 16 (4) | 7 (1) | 6 (2) | |
| Private health insurance ± others | 2866 (57) | 204 (51) | 260 (46) | 164 (59) | |
| Medicaid ± others | 482 (10) | 98 (24) | 192 (34) | 50 (18) | |
| Medicare ± others | 1387 (28) | 57 (14) | 64 (11) | 36 (13) | |
| Other | 134 (3) | 19 (5) | 21 (4) | 9 (3) | |
| Missing | 25 (0) | 5 (1) | 4 (1) | 7 (3) | |
| Marital status | |||||
| Single | 565 (11) | 127 (32) | 155 (27) | 47 (17) | |
| Married | 3689 (74) | 209 (52) | 318 (56) | 185 (67) | |
| Separated | 54 (1) | 8 (2) | 13 (2) | 3 (1) | |
| Divorced | 441 (9) | 39 (10) | 45 (8) | 13 (5) | |
| Widowed | 154 (3) | 7 (2) | 13 (2) | 6 (2) | |
| Not reported | 112 (2) | 13 (3) | 20 (4) | 23 (8) | |
| Highest level of education completed | <.01 | ||||
| No primary | 5 (0) | 0 (0) | 2 (0) | 1 (0) | |
| Less than primary | 3 (0) | 0 (0) | 4 (1) | 0 (0) | |
| Primary | 4 (0) | 0 (0) | 22 (4) | 3 (1) | |
| Lower secondary | 90 (2) | 15 (4) | 31 (5) | 7 (3) | |
| Upper secondary | 1241 (25) | 139 (34) | 188 (33) | 51 (18) | |
| Postsecondary (vocational) | 430 (9) | 42 (10) | 42 (7) | 20 (7) | |
| Tertiary (4-y degree) | 1341 (27) | 77 (19) | 79 (14) | 79 (29) | |
| Tertiary (2-y degree) | 299 (6) | 18 (4) | 29 (5) | 13 (5) | |
| Advanced research degree | 228 (5) | 15 (4) | 15 (3) | 35 (13) | |
| Not reported | 1374 (27) | 97 (24) | 152 (27) | 68 (25) | |
| Current or most recent work status before illness | |||||
| Full time | 1759 (35) | 151 (37) | 194 (34) | 100 (36) | |
| Part time | 207 (4) | 9 (2) | 15 (3) | 5 (2) | |
| Unemployed | 391 (8) | 46 (11) | 102 (18) | 30 (11) | |
| Medical disability | 640 (13) | 81 (20) | 62 (11) | 31 (11) | |
| Retired | 1288 (26) | 45 (11) | 49 (9) | 29 (10) | |
| Not reported | 730 (15) | 71 (18) | 142 (25) | 82 (30) | |
| Disease | |||||
| AML | 2238 (45) | 217 (54) | 231 (41) | 150 (54) | |
| ALL | 502 (10) | 85 (21) | 200 (35) | 56 (20) | |
| MDS | 1852 (37) | 74 (18) | 103 (18) | 44 (16) | |
| MPN | 423 (8) | 27 (7) | 30 (5) | 27 (10) | |
| Refined disease risk index | <.01 | ||||
| Low | 172 (3) | 15 (4) | 27 (5) | 14 (5) | |
| Intermediate | 2801 (56) | 236 (59) | 341 (60) | 173 (62) | |
| High | 1544 (31) | 111 (28) | 145 (26) | 75 (27) | |
| Very high | 106 (2) | 12 (3) | 16 (3) | 4 (1) | |
| N/A (disease not classifiable) | 284 (6) | 14 (3) | 18 (3) | 7 (3) | |
| Missing | 108 (2) | 15 (4) | 17 (3) | 4 (1) | |
| Donor type | <.01 | ||||
| HLA-identical sibling | 1060 (21) | 69 (17) | 147 (26) | 63 (23) | |
| Haploidentical | 385 (8) | 93 (23) | 85 (15) | 28 (10) | |
| Well-matched unrelated (8/8) | 2604 (52) | 80 (20) | 125 (22) | 81 (29) | |
| Partially-matched unrelated (7/8) | 481 (10) | 63 (16) | 77 (14) | 25 (9) | |
| Cord blood | 485 (10) | 98 (24) | 130 (23) | 80 (29) | |
| Donor/recipient CMV serostatus | |||||
| +/+ | 1193 (24) | 162 (40) | 233 (41) | 131 (47) | |
| +/− | 506 (10) | 29 (7) | 30 (5) | 11 (4) | |
| −/+ | 1773 (35) | 157 (39) | 232 (41) | 114 (41) | |
| −/− | 1502 (30) | 51 (13) | 65 (12) | 21 (8) | |
| Not reported | 41 (1) | 4 (1) | 4 (1) | 0 (0) | |
| Donor/recipient sex match | |||||
| M-M | 1904 (38) | 82 (20) | 165 (29) | 71 (26) | |
| M-F | 1289 (26) | 85 (21) | 124 (22) | 62 (22) | |
| F-M | 890 (18) | 86 (21) | 120 (21) | 53 (19) | |
| F-F | 736 (15) | 106 (26) | 108 (19) | 57 (21) | |
| Not reported | 196 (4) | 44 (11) | 47 (8) | 34 (12) | |
| Graft type | <.01 | ||||
| Bone marrow | 649 (13) | 57 (14) | 66 (12) | 31 (11) | |
| Peripheral blood | 3881 (77) | 248 (62) | 368 (65) | 166 (60) | |
| Cord blood | 485 (10) | 98 (24) | 130 (23) | 80 (29) | |
| Conditioning intensity | <.01 | ||||
| MAC | 2602 (52) | 267 (66) | 383 (68) | 174 (63) | |
| RIC/NMA | 2381 (47) | 131 (33) | 180 (32) | 103 (37) | |
| Not reported | 32 (1) | 5 (1) | 1 (0) | 0 (0) | |
| Conditioning TBI dose | |||||
| No TBI | 3328 (66) | 202 (50) | 277 (49) | 124 (45) | |
| ≤450 cGy | 838 (17) | 71 (18) | 92 (16) | 65 (23) | |
| >450 cGy | 839 (17) | 128 (32) | 193 (34) | 86 (31) | |
| 99 | 10 (0) | 2 (0) | 2 (0) | 2 (1) | |
| GVHD prophylaxis | <.01 | ||||
| PT-Cy +/− others | 553 (11) | 105 (26) | 95 (17) | 34 (12) | |
| CNI + MMF +/− others (except PT-Cy) | 1425 (28) | 137 (34) | 176 (31) | 111 (40) | |
| CNI + MTX +/− others (except PT-Cy, MMF) | 2568 (51) | 139 (34) | 235 (42) | 106 (38) | |
| Other | 467 (9) | 21 (5) | 57 (10) | 26 (9) | |
| Not reported | 2 (0) | 1 (0) | 1 (0) | 0 (0) | |
| In vivo T-cell depletion (ATG/alemtuzumab) | |||||
| No | 3777 (75) | 323 (80) | 462 (82) | 245 (88) | |
| Yes | 1234 (25) | 80 (20) | 102 (18) | 32 (12) | |
| Missing | 4 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Year of HCT | <.01 | ||||
| 2008 | 482 (10) | 31 (8) | 59 (10) | 18 (6) | |
| 2009 | 489 (10) | 23 (6) | 58 (10) | 23 (8) | |
| 2010 | 363 (7) | 30 (7) | 46 (8) | 20 (7) | |
| 2011 | 271 (5) | 18 (4) | 37 (7) | 15 (5) | |
| 2012 | 274 (5) | 17 (4) | 37 (7) | 10 (4) | |
| 2013 | 513 (10) | 27 (7) | 49 (9) | 29 (10) | |
| 2014 | 608 (12) | 44 (11) | 61 (11) | 20 (7) | |
| 2015 | 606 (12) | 71 (18) | 48 (9) | 42 (15) | |
| 2016 | 532 (11) | 56 (14) | 54 (10) | 37 (13) | |
| 2017 | 438 (9) | 35 (9) | 64 (11) | 25 (9) | |
| 2018 | 439 (9) | 51 (13) | 51 (9) | 38 (14) | |
| Median follow-up of survivors (range), mo | 66 (3-147) | 51 (3-144) | 60 (3-143) | 59 (7-141) |
| Characteristic . | Non-Hispanic White . | Non-Hispanic Black . | Hispanic . | Asian . | P value . |
|---|---|---|---|---|---|
| No. of patients | 5015 | 403 | 564 | 277 | |
| No. of centers | 131 | 83 | 91 | 70 | |
| Age at HCT, y | <.01 | ||||
| Median (min-max) | 58.8 (18-83) | 48.7 (18-75) | 44.9 (18-74) | 49 (18-74) | |
| 18-29 | 352 (7) | 66 (16) | 149 (26) | 46 (17) | |
| 30-39 | 374 (7) | 67 (17) | 102 (18) | 49 (18) | |
| 40-49 | 648 (13) | 81 (20) | 87 (15) | 50 (18) | |
| 50-59 | 1332 (27) | 97 (24) | 111 (20) | 62 (22) | |
| 60-69 | 1844 (37) | 80 (20) | 100 (18) | 56 (20) | |
| ≥70 | 465 (9) | 12 (3) | 15 (3) | 14 (5) | |
| Recipient sex | |||||
| Male | 2902 (58) | 188 (47) | 309 (55) | 140 (51) | |
| Female | 2113 (42) | 215 (53) | 255 (45) | 137 (49) | |
| Karnofsky score | <.01 | ||||
| <90 | 2152 (43) | 187 (46) | 202 (36) | 109 (39) | |
| ≥90 | 2801 (56) | 210 (52) | 351 (62) | 162 (58) | |
| Missing | 62 (1) | 6 (1) | 11 (2) | 6 (2) | |
| HCT-CI | <.01 | ||||
| 0 | 1013 (20) | 80 (20) | 172 (30) | 75 (27) | |
| 1-2 | 1429 (28) | 122 (30) | 173 (31) | 74 (27) | |
| 3+ | 2545 (51) | 200 (50) | 218 (39) | 127 (46) | |
| Missing | 28 (1) | 1 (0) | 1 (0) | 1 (0) | |
| Median household income by ZIP code | <.01 | ||||
| <$48 000 | 1150 (23) | 167 (41) | 221 (39) | 24 (9) | |
| $48 000-$60 999 | 1216 (24) | 106 (26) | 131 (23) | 47 (17) | |
| $61 000-$79 999 | 1346 (27) | 69 (17) | 133 (24) | 73 (26) | |
| ≥$80 000 | 1249 (25) | 57 (14) | 64 (11) | 129 (47) | |
| Missing | 54 (1) | 4 (1) | 15 (3) | 4 (1) | |
| Health insurance type | <.01 | ||||
| No insurance | 25 (0) | 4 (1) | 16 (3) | 5 (2) | |
| Disability insurance ± others | 96 (2) | 16 (4) | 7 (1) | 6 (2) | |
| Private health insurance ± others | 2866 (57) | 204 (51) | 260 (46) | 164 (59) | |
| Medicaid ± others | 482 (10) | 98 (24) | 192 (34) | 50 (18) | |
| Medicare ± others | 1387 (28) | 57 (14) | 64 (11) | 36 (13) | |
| Other | 134 (3) | 19 (5) | 21 (4) | 9 (3) | |
| Missing | 25 (0) | 5 (1) | 4 (1) | 7 (3) | |
| Marital status | |||||
| Single | 565 (11) | 127 (32) | 155 (27) | 47 (17) | |
| Married | 3689 (74) | 209 (52) | 318 (56) | 185 (67) | |
| Separated | 54 (1) | 8 (2) | 13 (2) | 3 (1) | |
| Divorced | 441 (9) | 39 (10) | 45 (8) | 13 (5) | |
| Widowed | 154 (3) | 7 (2) | 13 (2) | 6 (2) | |
| Not reported | 112 (2) | 13 (3) | 20 (4) | 23 (8) | |
| Highest level of education completed | <.01 | ||||
| No primary | 5 (0) | 0 (0) | 2 (0) | 1 (0) | |
| Less than primary | 3 (0) | 0 (0) | 4 (1) | 0 (0) | |
| Primary | 4 (0) | 0 (0) | 22 (4) | 3 (1) | |
| Lower secondary | 90 (2) | 15 (4) | 31 (5) | 7 (3) | |
| Upper secondary | 1241 (25) | 139 (34) | 188 (33) | 51 (18) | |
| Postsecondary (vocational) | 430 (9) | 42 (10) | 42 (7) | 20 (7) | |
| Tertiary (4-y degree) | 1341 (27) | 77 (19) | 79 (14) | 79 (29) | |
| Tertiary (2-y degree) | 299 (6) | 18 (4) | 29 (5) | 13 (5) | |
| Advanced research degree | 228 (5) | 15 (4) | 15 (3) | 35 (13) | |
| Not reported | 1374 (27) | 97 (24) | 152 (27) | 68 (25) | |
| Current or most recent work status before illness | |||||
| Full time | 1759 (35) | 151 (37) | 194 (34) | 100 (36) | |
| Part time | 207 (4) | 9 (2) | 15 (3) | 5 (2) | |
| Unemployed | 391 (8) | 46 (11) | 102 (18) | 30 (11) | |
| Medical disability | 640 (13) | 81 (20) | 62 (11) | 31 (11) | |
| Retired | 1288 (26) | 45 (11) | 49 (9) | 29 (10) | |
| Not reported | 730 (15) | 71 (18) | 142 (25) | 82 (30) | |
| Disease | |||||
| AML | 2238 (45) | 217 (54) | 231 (41) | 150 (54) | |
| ALL | 502 (10) | 85 (21) | 200 (35) | 56 (20) | |
| MDS | 1852 (37) | 74 (18) | 103 (18) | 44 (16) | |
| MPN | 423 (8) | 27 (7) | 30 (5) | 27 (10) | |
| Refined disease risk index | <.01 | ||||
| Low | 172 (3) | 15 (4) | 27 (5) | 14 (5) | |
| Intermediate | 2801 (56) | 236 (59) | 341 (60) | 173 (62) | |
| High | 1544 (31) | 111 (28) | 145 (26) | 75 (27) | |
| Very high | 106 (2) | 12 (3) | 16 (3) | 4 (1) | |
| N/A (disease not classifiable) | 284 (6) | 14 (3) | 18 (3) | 7 (3) | |
| Missing | 108 (2) | 15 (4) | 17 (3) | 4 (1) | |
| Donor type | <.01 | ||||
| HLA-identical sibling | 1060 (21) | 69 (17) | 147 (26) | 63 (23) | |
| Haploidentical | 385 (8) | 93 (23) | 85 (15) | 28 (10) | |
| Well-matched unrelated (8/8) | 2604 (52) | 80 (20) | 125 (22) | 81 (29) | |
| Partially-matched unrelated (7/8) | 481 (10) | 63 (16) | 77 (14) | 25 (9) | |
| Cord blood | 485 (10) | 98 (24) | 130 (23) | 80 (29) | |
| Donor/recipient CMV serostatus | |||||
| +/+ | 1193 (24) | 162 (40) | 233 (41) | 131 (47) | |
| +/− | 506 (10) | 29 (7) | 30 (5) | 11 (4) | |
| −/+ | 1773 (35) | 157 (39) | 232 (41) | 114 (41) | |
| −/− | 1502 (30) | 51 (13) | 65 (12) | 21 (8) | |
| Not reported | 41 (1) | 4 (1) | 4 (1) | 0 (0) | |
| Donor/recipient sex match | |||||
| M-M | 1904 (38) | 82 (20) | 165 (29) | 71 (26) | |
| M-F | 1289 (26) | 85 (21) | 124 (22) | 62 (22) | |
| F-M | 890 (18) | 86 (21) | 120 (21) | 53 (19) | |
| F-F | 736 (15) | 106 (26) | 108 (19) | 57 (21) | |
| Not reported | 196 (4) | 44 (11) | 47 (8) | 34 (12) | |
| Graft type | <.01 | ||||
| Bone marrow | 649 (13) | 57 (14) | 66 (12) | 31 (11) | |
| Peripheral blood | 3881 (77) | 248 (62) | 368 (65) | 166 (60) | |
| Cord blood | 485 (10) | 98 (24) | 130 (23) | 80 (29) | |
| Conditioning intensity | <.01 | ||||
| MAC | 2602 (52) | 267 (66) | 383 (68) | 174 (63) | |
| RIC/NMA | 2381 (47) | 131 (33) | 180 (32) | 103 (37) | |
| Not reported | 32 (1) | 5 (1) | 1 (0) | 0 (0) | |
| Conditioning TBI dose | |||||
| No TBI | 3328 (66) | 202 (50) | 277 (49) | 124 (45) | |
| ≤450 cGy | 838 (17) | 71 (18) | 92 (16) | 65 (23) | |
| >450 cGy | 839 (17) | 128 (32) | 193 (34) | 86 (31) | |
| 99 | 10 (0) | 2 (0) | 2 (0) | 2 (1) | |
| GVHD prophylaxis | <.01 | ||||
| PT-Cy +/− others | 553 (11) | 105 (26) | 95 (17) | 34 (12) | |
| CNI + MMF +/− others (except PT-Cy) | 1425 (28) | 137 (34) | 176 (31) | 111 (40) | |
| CNI + MTX +/− others (except PT-Cy, MMF) | 2568 (51) | 139 (34) | 235 (42) | 106 (38) | |
| Other | 467 (9) | 21 (5) | 57 (10) | 26 (9) | |
| Not reported | 2 (0) | 1 (0) | 1 (0) | 0 (0) | |
| In vivo T-cell depletion (ATG/alemtuzumab) | |||||
| No | 3777 (75) | 323 (80) | 462 (82) | 245 (88) | |
| Yes | 1234 (25) | 80 (20) | 102 (18) | 32 (12) | |
| Missing | 4 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Year of HCT | <.01 | ||||
| 2008 | 482 (10) | 31 (8) | 59 (10) | 18 (6) | |
| 2009 | 489 (10) | 23 (6) | 58 (10) | 23 (8) | |
| 2010 | 363 (7) | 30 (7) | 46 (8) | 20 (7) | |
| 2011 | 271 (5) | 18 (4) | 37 (7) | 15 (5) | |
| 2012 | 274 (5) | 17 (4) | 37 (7) | 10 (4) | |
| 2013 | 513 (10) | 27 (7) | 49 (9) | 29 (10) | |
| 2014 | 608 (12) | 44 (11) | 61 (11) | 20 (7) | |
| 2015 | 606 (12) | 71 (18) | 48 (9) | 42 (15) | |
| 2016 | 532 (11) | 56 (14) | 54 (10) | 37 (13) | |
| 2017 | 438 (9) | 35 (9) | 64 (11) | 25 (9) | |
| 2018 | 439 (9) | 51 (13) | 51 (9) | 38 (14) | |
| Median follow-up of survivors (range), mo | 66 (3-147) | 51 (3-144) | 60 (3-143) | 59 (7-141) |
ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; ATG, antithymocyte globulin; CMV, cytomegalovirus; CNI, calcineurin inhibitors; F, female; HCT-CI; HCT comorbidity index; M, male; MAC, myeloablative conditioning; MDS, myelodysplastic syndrome; MMF, mycophenolate mofetil; MPN; myeloproliferative neoplasm; MTX, methotrexate; NMA, nonmyeloablative; PT-Cy; posttransplant cyclophosphamide; RIC, reduced-intensity conditioning; TBI, total body irradiation.