Patient characteristics and overall transplantation outcome
. | All patients . | RIC . | Conventional . | P . |
|---|---|---|---|---|
| No. patients | 129 | 57 | 72 | |
| Median age, y (range) | 42 (5-72) | 50 (5-72) | 37 (8-64) | .02 |
| Male sex, no. (%) | 78 (60) | 33 (58) | 45 (62) | |
| Female donor, no. (%) | 43 (33) | 21 (37) | 22 (31) | |
| Patient CMV seropositive (IgG), no. (%) | 79 (61) | 35 (61) | 44 (61) | |
| Seronegative donors, no. (%) | 29 (33) | 17 (30) | 12 (17) | |
| Underlying disease, no. (%) | ||||
| Acute leukemia or myelodysplasia | 107 (83) | 46 (81) | 61 (85) | |
| Chronic myelogenous leukemia | 5 (4) | 3 (5) | 2 (3) | |
| Lymphoma | 8 (6) | 6 (10) | 2 (3) | |
| Multiple myeloma or CLL | 3 (2) | 1 (2) | 2 (3) | |
| Other | 6 (5) | 1 (2) | 5 (7) | |
| Disease status at transplantation, no. (%)* | ||||
| Early | 44 (34) | 20 (35) | 24 (33) | |
| Advanced | 85 (66) | 37 (65) | 48 (67) | |
| Prior autologous HSCT, no. (%) | 10 (8) | 6 (11) | 4 (6) | |
| Donor type, no. (%) | ||||
| HLA-identical sibling | 71 (55) | 28 (50) | 43 (60) | |
| Alternative (VUD/family mismatched) | 58 | 29 | 29 | |
| Stem cell source, no. (%) | ||||
| Peripheral blood | 99 (77) | 49 (86) | 50 (69) | .03 |
| Bone marrow | 28 | 8 | 20 | |
| Cord blood | 2 | — | 2 | |
| Transplantation year, no. (%) | ||||
| 1998-2000 | 32 (25) | 11 (19) | 21 (29) | |
| 2001-2004 | 97 (75) | 46 (81) | 51 (71) | |
| ATG or alemtuzumab in conditioning, no. (%) | 60 (47) | 34 (60) | 26 (36) | < .01 |
| Ex vivo T-cell depletion, no. (%) | 22 (17) | 16 (28) | 6 (8) | .04 |
| Conditioning regimen, no. (%) | ||||
| TBI-based conventional myeloablative therapy | — | — | 49 (68) | |
| Chemotherapy-only conventional myeloablative therapy | — | — | 23 (32) | |
| Reduced-intensity therapy | ||||
| Alkylating agent(s) + fludarabine | — | 48 (84) | — | |
| Low-dose TBI (≤ 4 Gy) + fludarabine | — | 9 (16) | — | |
| GVHD prophylaxis, no. (%) | .04 | |||
| CsA ± steroids ± ATG | 36 (28) | 22 (39) | 14 (19) | |
| CsA or Tacro + MTX ± ATG | 77 (60) | 21 (37) | 56 (78) | |
| CsA or Tacro + MMF ± ATG | 16 (12) | 14 (25) | 2 (3) | |
| Median d of neutropenia (range)† | 18 (1-123) | 10 (1-123) | 19 (8-93) | .03 |
| Less than 7 d of neutropenia, no. (%) | 20 (16) | 14 (25) | 6 (8) | .02 |
| Less than 21 d of neutropenia, no. (%) | 81 (63) | 41 (72) | 40 (56) | |
| Stable donor engraftment, no. (%) | 118 (91) | 56 (97) | 62 (87) | .04 |
| No. developing grades II-IV aGVHD (% CumInc, 95% CI) | 53 (36, 28-44) | 17 (26, 14-38) | 36 (44, 32-56) | .03 |
| No. developed cGVHD (% CumInc, 95% CI) | 45 (30, 18-42) | 24 (34, 20-48) | 21 (26, 16-36) | |
| 2-y nonrelapse mortality, % CumInc (95% CI) | 30 (19-39) | 29 (18-48) | 30 (19-39) | |
| 2-y disease relapse, % CumInc (95% CI) | 33 (19-45) | 32 (13-45) | 35 (20-50) | |
| Overall survival, % CumInc (95% CI) | 42 (30-50) | 42 (24-52) | 42 (25-53) | |
| Median d follow-up (range) | 287 (2-1414) | 253 (2-1326) | 365 (7-1414) | .1 |
. | All patients . | RIC . | Conventional . | P . |
|---|---|---|---|---|
| No. patients | 129 | 57 | 72 | |
| Median age, y (range) | 42 (5-72) | 50 (5-72) | 37 (8-64) | .02 |
| Male sex, no. (%) | 78 (60) | 33 (58) | 45 (62) | |
| Female donor, no. (%) | 43 (33) | 21 (37) | 22 (31) | |
| Patient CMV seropositive (IgG), no. (%) | 79 (61) | 35 (61) | 44 (61) | |
| Seronegative donors, no. (%) | 29 (33) | 17 (30) | 12 (17) | |
| Underlying disease, no. (%) | ||||
| Acute leukemia or myelodysplasia | 107 (83) | 46 (81) | 61 (85) | |
| Chronic myelogenous leukemia | 5 (4) | 3 (5) | 2 (3) | |
| Lymphoma | 8 (6) | 6 (10) | 2 (3) | |
| Multiple myeloma or CLL | 3 (2) | 1 (2) | 2 (3) | |
| Other | 6 (5) | 1 (2) | 5 (7) | |
| Disease status at transplantation, no. (%)* | ||||
| Early | 44 (34) | 20 (35) | 24 (33) | |
| Advanced | 85 (66) | 37 (65) | 48 (67) | |
| Prior autologous HSCT, no. (%) | 10 (8) | 6 (11) | 4 (6) | |
| Donor type, no. (%) | ||||
| HLA-identical sibling | 71 (55) | 28 (50) | 43 (60) | |
| Alternative (VUD/family mismatched) | 58 | 29 | 29 | |
| Stem cell source, no. (%) | ||||
| Peripheral blood | 99 (77) | 49 (86) | 50 (69) | .03 |
| Bone marrow | 28 | 8 | 20 | |
| Cord blood | 2 | — | 2 | |
| Transplantation year, no. (%) | ||||
| 1998-2000 | 32 (25) | 11 (19) | 21 (29) | |
| 2001-2004 | 97 (75) | 46 (81) | 51 (71) | |
| ATG or alemtuzumab in conditioning, no. (%) | 60 (47) | 34 (60) | 26 (36) | < .01 |
| Ex vivo T-cell depletion, no. (%) | 22 (17) | 16 (28) | 6 (8) | .04 |
| Conditioning regimen, no. (%) | ||||
| TBI-based conventional myeloablative therapy | — | — | 49 (68) | |
| Chemotherapy-only conventional myeloablative therapy | — | — | 23 (32) | |
| Reduced-intensity therapy | ||||
| Alkylating agent(s) + fludarabine | — | 48 (84) | — | |
| Low-dose TBI (≤ 4 Gy) + fludarabine | — | 9 (16) | — | |
| GVHD prophylaxis, no. (%) | .04 | |||
| CsA ± steroids ± ATG | 36 (28) | 22 (39) | 14 (19) | |
| CsA or Tacro + MTX ± ATG | 77 (60) | 21 (37) | 56 (78) | |
| CsA or Tacro + MMF ± ATG | 16 (12) | 14 (25) | 2 (3) | |
| Median d of neutropenia (range)† | 18 (1-123) | 10 (1-123) | 19 (8-93) | .03 |
| Less than 7 d of neutropenia, no. (%) | 20 (16) | 14 (25) | 6 (8) | .02 |
| Less than 21 d of neutropenia, no. (%) | 81 (63) | 41 (72) | 40 (56) | |
| Stable donor engraftment, no. (%) | 118 (91) | 56 (97) | 62 (87) | .04 |
| No. developing grades II-IV aGVHD (% CumInc, 95% CI) | 53 (36, 28-44) | 17 (26, 14-38) | 36 (44, 32-56) | .03 |
| No. developed cGVHD (% CumInc, 95% CI) | 45 (30, 18-42) | 24 (34, 20-48) | 21 (26, 16-36) | |
| 2-y nonrelapse mortality, % CumInc (95% CI) | 30 (19-39) | 29 (18-48) | 30 (19-39) | |
| 2-y disease relapse, % CumInc (95% CI) | 33 (19-45) | 32 (13-45) | 35 (20-50) | |
| Overall survival, % CumInc (95% CI) | 42 (30-50) | 42 (24-52) | 42 (25-53) | |
| Median d follow-up (range) | 287 (2-1414) | 253 (2-1326) | 365 (7-1414) | .1 |
CLL indicates chronic lymphocytic leukemia; VUD, volunteer unrelated donor; CsA, cyclosporine A; MTX, methotrexate; MMF, mycophenolate mofetil; Tacro, tacrolimus; and —, not applicable.
Early indicates acute leukemia and myelodysplastic syndrome in first complete remission after chemotherapy (< 5% blasts), previously untreated low-risk MDS, and chronic myeloid leukemia in first chronic phase; advanced, malignancies in a phase beyond the early phase, and multiple myeloma, CLL, and non-Hodgkin lymphoma, Hodgkin disease, and solid tumors.
Neutropenia is defined as < 0.5 × 109 cells/L.