Characteristics of adult patients who received first allo-HCT for AML, ALL, or MDS between 2008 and 2018 in the United States and developed cGVHD, by race/ethnicity (n = 6675)
| Characteristic . | Non-Hispanic White . | Non-Hispanic Black . | Hispanic . | Asian . | P value . |
|---|---|---|---|---|---|
| No. of patients | 5360 | 420 | 590 | 305 | |
| No. of centers | 128 | 90 | 96 | 70 | |
| Age at HCT, y | <.01 | ||||
| Median (min-max) | 59 (18-81) | 51 (18-76) | 44 (18-76) | 53 (19-74) | |
| 18-29 | 367 (7) | 53 (13) | 146 (25) | 30 (10) | |
| 30-39 | 415 (8) | 65 (15) | 109 (18) | 47 (15) | |
| 40-49 | 725 (14) | 84 (20) | 116 (20) | 63 (21) | |
| 50-59 | 1416 (26) | 105 (25) | 109 (18) | 74 (24) | |
| 60-69 | 1966 (37) | 99 (24) | 100 (17) | 68 (22) | |
| ≥70 | 471 (9) | 14 (3) | 10 (2) | 23 (8) | |
| Recipient sex | |||||
| Male | 3154 (59) | 194 (46) | 305 (52) | 153 (50) | |
| Female | 2206 (41) | 226 (54) | 285 (48) | 152 (50) | |
| Karnofsky score | <.01 | ||||
| <90 | 2143 (40) | 183 (44) | 195 (33) | 102 (33) | |
| ≥90 | 3148 (59) | 232 (55) | 386 (65) | 199 (65) | |
| Missing | 69 (1) | 5 (1) | 9 (2) | 4 (1) | |
| HCT-CI | <.01 | ||||
| 0 | 1237 (23) | 95 (23) | 190 (32) | 85 (28) | |
| 1-2 | 1566 (29) | 122 (29) | 185 (31) | 92 (30) | |
| 3+ | 2527 (47) | 201 (48) | 210 (36) | 127 (42) | |
| Missing | 30 (1) | 2 (0) | 5 (1) | 1 (0) | |
| Median household income by ZIP code | <.01 | ||||
| <$48 000 | 1126 (21) | 185 (44) | 221 (37) | 40 (13) | |
| $48 000-$60 999 | 1351 (25) | 98 (23) | 144 (24) | 59 (19) | |
| $61 000-$79 999 | 1439 (27) | 85 (20) | 131 (22) | 82 (27) | |
| ≥$80 000 | 1383 (26) | 48 (11) | 76 (13) | 118 (39) | |
| Missing | 61 (1) | 4 (1) | 18 (3) | 6 (2) | |
| Health insurance type | <.01 | ||||
| No insurance | 21 (0) | 6 (1) | 14 (2) | 4 (1) | |
| Disability insurance ± others | 120 (2) | 16 (4) | 9 (2) | 11 (4) | |
| Private health insurance ± others | 3198 (60) | 219 (52) | 277 (47) | 183 (60) | |
| Medicaid ± others | 475 (9) | 87 (21) | 187 (32) | 51 (17) | |
| Medicare ± others | 1410 (26) | 71 (17) | 68 (12) | 45 (15) | |
| Other | 121 (2) | 18 (4) | 32 (5) | 8 (3) | |
| Missing | 15 (0) | 3 (1) | 3 (1) | 3 (1) | |
| Marital status | |||||
| Single | 599 (11) | 128 (30) | 152 (26) | 36 (12) | |
| Married | 4032 (75) | 220 (52) | 355 (60) | 222 (73) | |
| Separated | 58 (1) | 6 (1) | 17 (3) | 5 (2) | |
| Divorced | 439 (8) | 46 (11) | 43 (7) | 16 (5) | |
| Widowed | 134 (3) | 6 (1) | 6 (1) | 11 (4) | |
| Missing | 98 (2) | 14 (3) | 17 (3) | 15 (5) | |
| Highest level of education completed | <.01 | ||||
| No primary | 2 (0) | 0 (0) | 2 (0) | 3 (1) | |
| Less than primary | 4 (0) | 1 (0) | 8 (1) | 0 (0) | |
| Primary | 6 (0) | 0 (0) | 25 (4) | 1 (0) | |
| Lower secondary | 94 (2) | 15 (4) | 40 (7) | 6 (2) | |
| Upper secondary | 1285 (24) | 144 (34) | 181 (31) | 49 (16) | |
| Postsecondary (vocational) | 477 (9) | 41 (10) | 47 (8) | 12 (4) | |
| Tertiary (4-y degree) | 1470 (27) | 86 (20) | 82 (14) | 85 (28) | |
| Tertiary (2-y degree) | 310 (6) | 30 (7) | 26 (4) | 15 (5) | |
| Advanced research degree | 265 (5) | 20 (5) | 14 (2) | 33 (11) | |
| Missing | 1447 (27) | 83 (20) | 165 (28) | 101 (33) | |
| Current or most recent work status before illness | |||||
| Full time | 1968 (37) | 144 (34) | 194 (33) | 105 (34) | |
| Part time | 224 (4) | 11 (3) | 14 (2) | 7 (2) | |
| Unemployed | 426 (8) | 50 (12) | 114 (19) | 45 (15) | |
| Medical disability | 638 (12) | 83 (20) | 82 (14) | 38 (12) | |
| Retired | 1343 (25) | 54 (13) | 52 (9) | 40 (13) | |
| Missing | 761 (14) | 78 (19) | 134 (23) | 70 (23) | |
| Disease | |||||
| AML | 2405 (45) | 217 (52) | 255 (43) | 167 (55) | |
| ALL | 541 (10) | 84 (20) | 208 (35) | 55 (18) | |
| MDS | 1949 (36) | 82 (20) | 101 (17) | 62 (20) | |
| MPN | 465 (9) | 37 (9) | 26 (4) | 21 (7) | |
| Refined disease risk index | <.01 | ||||
| Low | 202 (4) | 16 (4) | 32 (5) | 15 (5) | |
| Intermediate | 3227 (60) | 251 (60) | 365 (62) | 207 (68) | |
| High | 1427 (27) | 114 (27) | 135 (23) | 70 (23) | |
| Very high | 73 (1) | 9 (2) | 21 (4) | 2 (1) | |
| N/A (disease not classifiable) | 308 (6) | 19 (5) | 22 (4) | 7 (2) | |
| Missing | 123 (2) | 11 (3) | 15 (3) | 4 (1) | |
| Donor type | <.01 | ||||
| HLA-identical sibling | 1452 (27) | 124 (30) | 227 (38) | 95 (31) | |
| Haploidentical | 301 (6) | 106 (25) | 76 (13) | 21 (7) | |
| Well-matched unrelated (8/8) | 2841 (53) | 77 (18) | 121 (21) | 108 (35) | |
| Partially-matched unrelated (7/8) | 457 (9) | 53 (13) | 77 (13) | 33 (11) | |
| Cord blood | 309 (6) | 60 (14) | 89 (15) | 48 (16) | |
| Donor/recipient CMV serostatus | |||||
| +/+ | 1317 (25) | 204 (49) | 278 (47) | 187 (61) | |
| +/− | 570 (11) | 34 (8) | 46 (8) | 7 (2) | |
| −/+ | 1762 (33) | 122 (29) | 195 (33) | 94 (31) | |
| −/− | 1663 (31) | 56 (13) | 66 (11) | 17 (6) | |
| Missing | 48 (1) | 4 (1) | 5 (1) | 0 (0) | |
| Donor/recipient sex match | |||||
| M-M | 2079 (39) | 90 (21) | 164 (28) | 79 (26) | |
| M-F | 1321 (25) | 97 (23) | 125 (21) | 82 (27) | |
| F-M | 1032 (19) | 94 (22) | 129 (22) | 63 (21) | |
| F-F | 843 (16) | 115 (27) | 151 (26) | 60 (20) | |
| Missing | 85 (2) | 24 (6) | 21 (4) | 21 (7) | |
| Graft type | <.01 | ||||
| Bone marrow | 540 (10) | 50 (12) | 64 (11) | 32 (10) | |
| Peripheral blood | 4511 (84) | 310 (74) | 437 (74) | 225 (74) | |
| Cord blood | 309 (6) | 60 (14) | 89 (15) | 48 (16) | |
| Conditioning intensity | <.01 | ||||
| MAC | 2817 (53) | 268 (64) | 416 (71) | 186 (61) | |
| RIC/NMA | 2514 (47) | 150 (36) | 174 (29) | 116 (38) | |
| Missing | 29 (1) | 2 (0) | 0 (0) | 3 (1) | |
| Conditioning TBI dose | |||||
| No TBI | 3745 (70) | 226 (54) | 306 (52) | 172 (56) | |
| ≥450 cGy | 751 (14) | 71 (17) | 66 (11) | 54 (18) | |
| >450 cGy | 857 (16) | 121 (29) | 217 (37) | 78 (26) | |
| Missing | 7 (0) | 2 (0) | 1 (0) | 1 (0) | |
| GVHD prophylaxis | <.01 | ||||
| PT-Cy +/− others | 455 (8) | 113 (27) | 86 (15) | 31 (10) | |
| CNI + MMF +/− others (except PT-Cy) | 1367 (26) | 95 (23) | 119 (20) | 78 (26) | |
| CNI + MTX +/− others (except PT-Cy, MMF) | 2927 (55) | 177 (42) | 290 (49) | 136 (45) | |
| Other | 608 (11) | 32 (8) | 93 (16) | 59 (19) | |
| Missing | 3 (0) | 3 (1) | 2 (0) | 1 (0) | |
| In vivo T-cell depletion (ATG/alemtuzumab) | |||||
| No | 4256 (79) | 346 (82) | 496 (84) | 260 (85) | |
| Yes | 1100 (21) | 74 (18) | 94 (16) | 45 (15) | |
| Missing | 4 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Year of HCT | <.01 | ||||
| 2008 | 555 (10) | 28 (7) | 72 (12) | 18 (6) | |
| 2009 | 543 (10) | 26 (6) | 54 (9) | 25 (8) | |
| 2010 | 430 (8) | 29 (7) | 51 (9) | 24 (8) | |
| 2011 | 295 (6) | 11 (3) | 34 (6) | 15 (5) | |
| 2012 | 294 (5) | 15 (4) | 43 (7) | 11 (4) | |
| 2013 | 507 (9) | 32 (8) | 67 (11) | 28 (9) | |
| 2014 | 676 (13) | 48 (11) | 62 (11) | 35 (11) | |
| 2015 | 604 (11) | 59 (14) | 50 (8) | 40 (13) | |
| 2016 | 556 (10) | 61 (15) | 58 (10) | 39 (13) | |
| 2017 | 460 (9) | 58 (14) | 48 (8) | 36 (12) | |
| 2018 | 440 (8) | 53 (13) | 51 (9) | 34 (11) | |
| Median follow-up of survivors (range), mo | 69 (9-147) | 54 (11-144) | 68 (12-146) | 59 (9-142) |
| Characteristic . | Non-Hispanic White . | Non-Hispanic Black . | Hispanic . | Asian . | P value . |
|---|---|---|---|---|---|
| No. of patients | 5360 | 420 | 590 | 305 | |
| No. of centers | 128 | 90 | 96 | 70 | |
| Age at HCT, y | <.01 | ||||
| Median (min-max) | 59 (18-81) | 51 (18-76) | 44 (18-76) | 53 (19-74) | |
| 18-29 | 367 (7) | 53 (13) | 146 (25) | 30 (10) | |
| 30-39 | 415 (8) | 65 (15) | 109 (18) | 47 (15) | |
| 40-49 | 725 (14) | 84 (20) | 116 (20) | 63 (21) | |
| 50-59 | 1416 (26) | 105 (25) | 109 (18) | 74 (24) | |
| 60-69 | 1966 (37) | 99 (24) | 100 (17) | 68 (22) | |
| ≥70 | 471 (9) | 14 (3) | 10 (2) | 23 (8) | |
| Recipient sex | |||||
| Male | 3154 (59) | 194 (46) | 305 (52) | 153 (50) | |
| Female | 2206 (41) | 226 (54) | 285 (48) | 152 (50) | |
| Karnofsky score | <.01 | ||||
| <90 | 2143 (40) | 183 (44) | 195 (33) | 102 (33) | |
| ≥90 | 3148 (59) | 232 (55) | 386 (65) | 199 (65) | |
| Missing | 69 (1) | 5 (1) | 9 (2) | 4 (1) | |
| HCT-CI | <.01 | ||||
| 0 | 1237 (23) | 95 (23) | 190 (32) | 85 (28) | |
| 1-2 | 1566 (29) | 122 (29) | 185 (31) | 92 (30) | |
| 3+ | 2527 (47) | 201 (48) | 210 (36) | 127 (42) | |
| Missing | 30 (1) | 2 (0) | 5 (1) | 1 (0) | |
| Median household income by ZIP code | <.01 | ||||
| <$48 000 | 1126 (21) | 185 (44) | 221 (37) | 40 (13) | |
| $48 000-$60 999 | 1351 (25) | 98 (23) | 144 (24) | 59 (19) | |
| $61 000-$79 999 | 1439 (27) | 85 (20) | 131 (22) | 82 (27) | |
| ≥$80 000 | 1383 (26) | 48 (11) | 76 (13) | 118 (39) | |
| Missing | 61 (1) | 4 (1) | 18 (3) | 6 (2) | |
| Health insurance type | <.01 | ||||
| No insurance | 21 (0) | 6 (1) | 14 (2) | 4 (1) | |
| Disability insurance ± others | 120 (2) | 16 (4) | 9 (2) | 11 (4) | |
| Private health insurance ± others | 3198 (60) | 219 (52) | 277 (47) | 183 (60) | |
| Medicaid ± others | 475 (9) | 87 (21) | 187 (32) | 51 (17) | |
| Medicare ± others | 1410 (26) | 71 (17) | 68 (12) | 45 (15) | |
| Other | 121 (2) | 18 (4) | 32 (5) | 8 (3) | |
| Missing | 15 (0) | 3 (1) | 3 (1) | 3 (1) | |
| Marital status | |||||
| Single | 599 (11) | 128 (30) | 152 (26) | 36 (12) | |
| Married | 4032 (75) | 220 (52) | 355 (60) | 222 (73) | |
| Separated | 58 (1) | 6 (1) | 17 (3) | 5 (2) | |
| Divorced | 439 (8) | 46 (11) | 43 (7) | 16 (5) | |
| Widowed | 134 (3) | 6 (1) | 6 (1) | 11 (4) | |
| Missing | 98 (2) | 14 (3) | 17 (3) | 15 (5) | |
| Highest level of education completed | <.01 | ||||
| No primary | 2 (0) | 0 (0) | 2 (0) | 3 (1) | |
| Less than primary | 4 (0) | 1 (0) | 8 (1) | 0 (0) | |
| Primary | 6 (0) | 0 (0) | 25 (4) | 1 (0) | |
| Lower secondary | 94 (2) | 15 (4) | 40 (7) | 6 (2) | |
| Upper secondary | 1285 (24) | 144 (34) | 181 (31) | 49 (16) | |
| Postsecondary (vocational) | 477 (9) | 41 (10) | 47 (8) | 12 (4) | |
| Tertiary (4-y degree) | 1470 (27) | 86 (20) | 82 (14) | 85 (28) | |
| Tertiary (2-y degree) | 310 (6) | 30 (7) | 26 (4) | 15 (5) | |
| Advanced research degree | 265 (5) | 20 (5) | 14 (2) | 33 (11) | |
| Missing | 1447 (27) | 83 (20) | 165 (28) | 101 (33) | |
| Current or most recent work status before illness | |||||
| Full time | 1968 (37) | 144 (34) | 194 (33) | 105 (34) | |
| Part time | 224 (4) | 11 (3) | 14 (2) | 7 (2) | |
| Unemployed | 426 (8) | 50 (12) | 114 (19) | 45 (15) | |
| Medical disability | 638 (12) | 83 (20) | 82 (14) | 38 (12) | |
| Retired | 1343 (25) | 54 (13) | 52 (9) | 40 (13) | |
| Missing | 761 (14) | 78 (19) | 134 (23) | 70 (23) | |
| Disease | |||||
| AML | 2405 (45) | 217 (52) | 255 (43) | 167 (55) | |
| ALL | 541 (10) | 84 (20) | 208 (35) | 55 (18) | |
| MDS | 1949 (36) | 82 (20) | 101 (17) | 62 (20) | |
| MPN | 465 (9) | 37 (9) | 26 (4) | 21 (7) | |
| Refined disease risk index | <.01 | ||||
| Low | 202 (4) | 16 (4) | 32 (5) | 15 (5) | |
| Intermediate | 3227 (60) | 251 (60) | 365 (62) | 207 (68) | |
| High | 1427 (27) | 114 (27) | 135 (23) | 70 (23) | |
| Very high | 73 (1) | 9 (2) | 21 (4) | 2 (1) | |
| N/A (disease not classifiable) | 308 (6) | 19 (5) | 22 (4) | 7 (2) | |
| Missing | 123 (2) | 11 (3) | 15 (3) | 4 (1) | |
| Donor type | <.01 | ||||
| HLA-identical sibling | 1452 (27) | 124 (30) | 227 (38) | 95 (31) | |
| Haploidentical | 301 (6) | 106 (25) | 76 (13) | 21 (7) | |
| Well-matched unrelated (8/8) | 2841 (53) | 77 (18) | 121 (21) | 108 (35) | |
| Partially-matched unrelated (7/8) | 457 (9) | 53 (13) | 77 (13) | 33 (11) | |
| Cord blood | 309 (6) | 60 (14) | 89 (15) | 48 (16) | |
| Donor/recipient CMV serostatus | |||||
| +/+ | 1317 (25) | 204 (49) | 278 (47) | 187 (61) | |
| +/− | 570 (11) | 34 (8) | 46 (8) | 7 (2) | |
| −/+ | 1762 (33) | 122 (29) | 195 (33) | 94 (31) | |
| −/− | 1663 (31) | 56 (13) | 66 (11) | 17 (6) | |
| Missing | 48 (1) | 4 (1) | 5 (1) | 0 (0) | |
| Donor/recipient sex match | |||||
| M-M | 2079 (39) | 90 (21) | 164 (28) | 79 (26) | |
| M-F | 1321 (25) | 97 (23) | 125 (21) | 82 (27) | |
| F-M | 1032 (19) | 94 (22) | 129 (22) | 63 (21) | |
| F-F | 843 (16) | 115 (27) | 151 (26) | 60 (20) | |
| Missing | 85 (2) | 24 (6) | 21 (4) | 21 (7) | |
| Graft type | <.01 | ||||
| Bone marrow | 540 (10) | 50 (12) | 64 (11) | 32 (10) | |
| Peripheral blood | 4511 (84) | 310 (74) | 437 (74) | 225 (74) | |
| Cord blood | 309 (6) | 60 (14) | 89 (15) | 48 (16) | |
| Conditioning intensity | <.01 | ||||
| MAC | 2817 (53) | 268 (64) | 416 (71) | 186 (61) | |
| RIC/NMA | 2514 (47) | 150 (36) | 174 (29) | 116 (38) | |
| Missing | 29 (1) | 2 (0) | 0 (0) | 3 (1) | |
| Conditioning TBI dose | |||||
| No TBI | 3745 (70) | 226 (54) | 306 (52) | 172 (56) | |
| ≥450 cGy | 751 (14) | 71 (17) | 66 (11) | 54 (18) | |
| >450 cGy | 857 (16) | 121 (29) | 217 (37) | 78 (26) | |
| Missing | 7 (0) | 2 (0) | 1 (0) | 1 (0) | |
| GVHD prophylaxis | <.01 | ||||
| PT-Cy +/− others | 455 (8) | 113 (27) | 86 (15) | 31 (10) | |
| CNI + MMF +/− others (except PT-Cy) | 1367 (26) | 95 (23) | 119 (20) | 78 (26) | |
| CNI + MTX +/− others (except PT-Cy, MMF) | 2927 (55) | 177 (42) | 290 (49) | 136 (45) | |
| Other | 608 (11) | 32 (8) | 93 (16) | 59 (19) | |
| Missing | 3 (0) | 3 (1) | 2 (0) | 1 (0) | |
| In vivo T-cell depletion (ATG/alemtuzumab) | |||||
| No | 4256 (79) | 346 (82) | 496 (84) | 260 (85) | |
| Yes | 1100 (21) | 74 (18) | 94 (16) | 45 (15) | |
| Missing | 4 (0) | 0 (0) | 0 (0) | 0 (0) | |
| Year of HCT | <.01 | ||||
| 2008 | 555 (10) | 28 (7) | 72 (12) | 18 (6) | |
| 2009 | 543 (10) | 26 (6) | 54 (9) | 25 (8) | |
| 2010 | 430 (8) | 29 (7) | 51 (9) | 24 (8) | |
| 2011 | 295 (6) | 11 (3) | 34 (6) | 15 (5) | |
| 2012 | 294 (5) | 15 (4) | 43 (7) | 11 (4) | |
| 2013 | 507 (9) | 32 (8) | 67 (11) | 28 (9) | |
| 2014 | 676 (13) | 48 (11) | 62 (11) | 35 (11) | |
| 2015 | 604 (11) | 59 (14) | 50 (8) | 40 (13) | |
| 2016 | 556 (10) | 61 (15) | 58 (10) | 39 (13) | |
| 2017 | 460 (9) | 58 (14) | 48 (8) | 36 (12) | |
| 2018 | 440 (8) | 53 (13) | 51 (9) | 34 (11) | |
| Median follow-up of survivors (range), mo | 69 (9-147) | 54 (11-144) | 68 (12-146) | 59 (9-142) |
Abbreviations are explained in Table 1.