Patient characteristics
| . | Old strategy (N = 153) . | New strategy (N = 125) . | P* . |
|---|---|---|---|
| Median age (range) | 46 (17-65) | 50 (18-66) | .42 |
| Recipient VZV seropositive (%) | 66 (99)† | 101 (98)‡ | .71 |
| Donor VZV seropositive (%) | 65 (100)† | 101 (98)‡ | .69 |
| VZV prophylaxis drug (%) | |||
| Acyclovir | 137 (90) | 65 (52) | <.01 |
| Valacyclovir | 16 (10) | 60 (48) | |
| Underlying disease (%) | |||
| Acute leukemia | 84 (55) | 75 (60) | .85 |
| MDS | 19 (12) | 11 (9) | |
| CLL/lymphoma | 26 (17) | 22 (18) | |
| CML | 10 (7) | 7 (5) | |
| Other | 14 (9) | 10 (8) | |
| Donor§(%) | |||
| Sibling | 87 (57) | 51 (41) | .02 |
| MUD | 48 (31) | 58 (46) | |
| MMUD | 16 (11) | 16 (13) | |
| Haploidentical | 2 (1) | 0 (0) | |
| Stem cell source (%) | |||
| Peripheral blood | 127 (83) | 120 (96) | <.01 |
| Bone marrow | 23 (15) | 4 (3) | |
| Umbilical cord | 3 (2) | 1 (1) | |
| Conditioning (%) | |||
| FluBuATG | 53 (35) | 36 (29) | .24 |
| FluBuATG + TBI | 89 (58) | 84 (67) | |
| Other‖ | 11 (7) | 5 (4) | |
| GVHD prophylaxis (%) | |||
| CSA+MTX | 147 (96) | 122 (98) | .71 |
| Other¶ | 6 (4) | 3 (2) | |
| Acute GVHD (%) | |||
| None | 83 (54) | 59 (47) | .36 |
| I | 35 (23) | 37 (30) | |
| II | 25 (16) | 25 (20) | |
| III | 9 (6) | 3 (2) | |
| IV | 1 (1) | 1 (1) | |
| Chronic GVHD (%) | |||
| None | 109 (71) | 67 (54) | <.01 |
| No systemic Rx | 19 (12) | 19 (15) | |
| Systemic Rx | 25 (16) | 39 (31) | |
| Significant GVHD#(%) | |||
| No | 93 (61) | 57 (46) | .02 |
| Yes | 60 (39) | 68 (54) |
| . | Old strategy (N = 153) . | New strategy (N = 125) . | P* . |
|---|---|---|---|
| Median age (range) | 46 (17-65) | 50 (18-66) | .42 |
| Recipient VZV seropositive (%) | 66 (99)† | 101 (98)‡ | .71 |
| Donor VZV seropositive (%) | 65 (100)† | 101 (98)‡ | .69 |
| VZV prophylaxis drug (%) | |||
| Acyclovir | 137 (90) | 65 (52) | <.01 |
| Valacyclovir | 16 (10) | 60 (48) | |
| Underlying disease (%) | |||
| Acute leukemia | 84 (55) | 75 (60) | .85 |
| MDS | 19 (12) | 11 (9) | |
| CLL/lymphoma | 26 (17) | 22 (18) | |
| CML | 10 (7) | 7 (5) | |
| Other | 14 (9) | 10 (8) | |
| Donor§(%) | |||
| Sibling | 87 (57) | 51 (41) | .02 |
| MUD | 48 (31) | 58 (46) | |
| MMUD | 16 (11) | 16 (13) | |
| Haploidentical | 2 (1) | 0 (0) | |
| Stem cell source (%) | |||
| Peripheral blood | 127 (83) | 120 (96) | <.01 |
| Bone marrow | 23 (15) | 4 (3) | |
| Umbilical cord | 3 (2) | 1 (1) | |
| Conditioning (%) | |||
| FluBuATG | 53 (35) | 36 (29) | .24 |
| FluBuATG + TBI | 89 (58) | 84 (67) | |
| Other‖ | 11 (7) | 5 (4) | |
| GVHD prophylaxis (%) | |||
| CSA+MTX | 147 (96) | 122 (98) | .71 |
| Other¶ | 6 (4) | 3 (2) | |
| Acute GVHD (%) | |||
| None | 83 (54) | 59 (47) | .36 |
| I | 35 (23) | 37 (30) | |
| II | 25 (16) | 25 (20) | |
| III | 9 (6) | 3 (2) | |
| IV | 1 (1) | 1 (1) | |
| Chronic GVHD (%) | |||
| None | 109 (71) | 67 (54) | <.01 |
| No systemic Rx | 19 (12) | 19 (15) | |
| Systemic Rx | 25 (16) | 39 (31) | |
| Significant GVHD#(%) | |||
| No | 93 (61) | 57 (46) | .02 |
| Yes | 60 (39) | 68 (54) |
ATG, antithymocyte globulin; Bu, busulfan; CLL, chronic lymphocytic leukemia; CML, chronic myeloid leukemia; CSA, cyclosporine A; Flu, fludarabine; MDS, myelodysplastic syndrome; MMUD; mismatched unrelated donor; MTX, methotrexate; MUD, matched unrelated donor; Rx, treatment; TBI, total body irradiation.
For ordinal variables, Mann-Whitney U test was used, and for nominal variables, χ2 or Fisher’s exact test was used as appropriate, using SigmaPlot 13 (Systat, San Jose, CA).
Of 67 recipients or 65 donors for whom VZV serostatus was available.
Of 103 recipients and donors for whom VZV serostatus was available.
Sibling = HLA-matched sibling; MUD = 8/8 allele-matched unrelated donor; MMUD (mismatched unrelated donor) included 6-7/8 allele-matched unrelated donors.
‖Other conditioning regimens included cyclophosphamide 200 mg/m2 plus ATG 4.5 mg/kg (n = 6 in the old group and n = 3 in the new group) and myeloablative conditioning composed of combinations of melphalan, fludarabine, etoposide, or busulfan with ATG (n = 2 in the old group and n = 2 in the new group) or cyclophosphamide, etoposide, or busulfan without ATG (n = 3 in the old group).
Other included cyclosporine (CSA) alone (n = 4 in the old group), prednisone (n = 1 in the old group and n = 2 in the new group), and mycophenolate (1 in each group).
Grades 2-4 acute GVHD and chronic GVHD requiring immunosuppression.