Table 4

Multivariate analyses of relapse and survival end points during the first 3 years after transplantation

End point: variableNumberHR (95% CI)P
Patients with hematologic malignancies (total number = 870) 
    Relapse*    
        HLA mismatch and mismatch direction    
            0 MM 48 0.7 (0.3-2.0) 0.547 
            1-2 MM/GVHD only 35 0.6 (0.3-1.3) 0.181 
            1-2 MM/rejection only 23 2.4 (1.2-4.8) 0.010 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 0.8 (0.5-1.1) 0.109 
            2 MM: bidirectional + GVHD 56 1.0 (0.6-1.8) 0.965 
            2 MM: bidirectional + rejection 42 1.0 (0.5-1.9) 0.988 
            2 MM: GVHD + rejection 3 0.0 (0.0- > >) 0.958 
    Transplantation-related mortality†    
        HLA mismatch and mismatch direction    
            0 MM 48 0.4 (0.2-0.8) 0.010 
            1-2 MM/GVHD only 35 0.5 (0.2-1.04) 0.062 
            1-2 MM/rejection only 23 1.0 (0.5-2.1) 0.933 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 1.3 (1.00-1.7) 0.047 
            2 MM: bidirectional + GVHD 56 1.0 (0.6-1.6) 0.982 
            2 MM: bidirectional + rejection 42 1.4 (0.9-2.3) 0.152 
            2 MM: GVHD + rejection 3 2.2 (0.5-9.0) 0.279 
    Treatment failure (relapse or death)†    
        HLA mismatch and mismatch direction    
            0 MM 48 0.5 (0.3-0.8) 0.004 
            1-2 MM/GVHD only 35 0.5 (0.3-0.9) 0.016 
            1-2 MM/rejection only 23 1.4 (0.9-2.4) 0.147 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 1.1 (0.9-1.4) 0.218 
            2 MM: bidirectional + GVHD 56 1.0 (0.7-1.4) 0.972 
            2 MM: bidirectional + rejection 42 1.4 (0.96-2.1) 0.080 
            2 MM: GVHD + rejection 3 1.3 (0.3-5.1) 0.744 
    Overall mortality† 
        HLA mismatch and mismatch direction    
            0 MM 48 0.5 (0.3-0.8) 0.007 
            1-2 MM/GVHD only 35 0.5 (0.3-0.9) 0.019 
            1-2 MM/rejection only 23 1.4 (0.8-2.4) 0.193 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 1.1 (0.9-1.4) 0.217 
            2 MM: bidirectional + GVHD 56 1.0 (0.7-1.5) 0.880 
            2 MM: bidirectional + rejection 42 1.3 (0.9-2.0) 0.154 
            2 MM: GVHD + rejection 3 1.4 (0.4-5.8) 0.614 
Patients with other diseases (total number = 332) 
    Transplantation-related mortality‡ 
        HLA mismatch and mismatch direction    
            0 MM 24 0.8 (0.4-1.7) 0.532 
            1-2 MM/GVHD only 23 0.9 (0.4-1.9) 0.782 
            1-2 MM/rejection only 17 0.9 (0.3-2.2) 0.766 
            1 bidirectional MM 115 1.0 (Reference)  
            2 bidirectional MM 112 1.4 (0.9-2.0) 0.140 
            2 MM: bidirectional + GVHD 27 1.8 (0.95-3.2) 0.072 
            2 MM: bidirectional + rejection 12 1.8 (0.8-4.1) 0.146 
            2 MM: GVHD + rejection 2 2.1 (0.3-15.3) 0.473 
End point: variableNumberHR (95% CI)P
Patients with hematologic malignancies (total number = 870) 
    Relapse*    
        HLA mismatch and mismatch direction    
            0 MM 48 0.7 (0.3-2.0) 0.547 
            1-2 MM/GVHD only 35 0.6 (0.3-1.3) 0.181 
            1-2 MM/rejection only 23 2.4 (1.2-4.8) 0.010 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 0.8 (0.5-1.1) 0.109 
            2 MM: bidirectional + GVHD 56 1.0 (0.6-1.8) 0.965 
            2 MM: bidirectional + rejection 42 1.0 (0.5-1.9) 0.988 
            2 MM: GVHD + rejection 3 0.0 (0.0- > >) 0.958 
    Transplantation-related mortality†    
        HLA mismatch and mismatch direction    
            0 MM 48 0.4 (0.2-0.8) 0.010 
            1-2 MM/GVHD only 35 0.5 (0.2-1.04) 0.062 
            1-2 MM/rejection only 23 1.0 (0.5-2.1) 0.933 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 1.3 (1.00-1.7) 0.047 
            2 MM: bidirectional + GVHD 56 1.0 (0.6-1.6) 0.982 
            2 MM: bidirectional + rejection 42 1.4 (0.9-2.3) 0.152 
            2 MM: GVHD + rejection 3 2.2 (0.5-9.0) 0.279 
    Treatment failure (relapse or death)†    
        HLA mismatch and mismatch direction    
            0 MM 48 0.5 (0.3-0.8) 0.004 
            1-2 MM/GVHD only 35 0.5 (0.3-0.9) 0.016 
            1-2 MM/rejection only 23 1.4 (0.9-2.4) 0.147 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 1.1 (0.9-1.4) 0.218 
            2 MM: bidirectional + GVHD 56 1.0 (0.7-1.4) 0.972 
            2 MM: bidirectional + rejection 42 1.4 (0.96-2.1) 0.080 
            2 MM: GVHD + rejection 3 1.3 (0.3-5.1) 0.744 
    Overall mortality† 
        HLA mismatch and mismatch direction    
            0 MM 48 0.5 (0.3-0.8) 0.007 
            1-2 MM/GVHD only 35 0.5 (0.3-0.9) 0.019 
            1-2 MM/rejection only 23 1.4 (0.8-2.4) 0.193 
            1 bidirectional MM 249 1.0 (Reference)  
            2 bidirectional MM 414 1.1 (0.9-1.4) 0.217 
            2 MM: bidirectional + GVHD 56 1.0 (0.7-1.5) 0.880 
            2 MM: bidirectional + rejection 42 1.3 (0.9-2.0) 0.154 
            2 MM: GVHD + rejection 3 1.4 (0.4-5.8) 0.614 
Patients with other diseases (total number = 332) 
    Transplantation-related mortality‡ 
        HLA mismatch and mismatch direction    
            0 MM 24 0.8 (0.4-1.7) 0.532 
            1-2 MM/GVHD only 23 0.9 (0.4-1.9) 0.782 
            1-2 MM/rejection only 17 0.9 (0.3-2.2) 0.766 
            1 bidirectional MM 115 1.0 (Reference)  
            2 bidirectional MM 112 1.4 (0.9-2.0) 0.140 
            2 MM: bidirectional + GVHD 27 1.8 (0.95-3.2) 0.072 
            2 MM: bidirectional + rejection 12 1.8 (0.8-4.1) 0.146 
            2 MM: GVHD + rejection 2 2.1 (0.3-15.3) 0.473 

ALL indicates acute lymphoblastic leukemia; AML, acute myeloid leukemia; CI, confidence interval; CML, chronic myeloid leukemia; GVHD, graft-versus-host disease; IBMTR, International Blood and Marrow Transplant Registry; MM, mismatch; NIMA, noninherited maternal antigen; NYBC, New York Blood Center; HR, hazard ratio; TNC, total nucleated cell; and CMV, cytomegalovirus.

*

The only other significant predictor in the multivariate model for relapse risk was IBMTR risk category (early stage ALL, AML or CML vs intermediate stage ALL, AML or CML vs late stage ALL, AML or CML vs unknown stage ALL, AML or CML vs other leukemia vs myelodysplasia vs other hematological malignancy) and GVHD prophylaxis (cyclosporin and steroids vs any methotrexate vs any tacrolimus without methotrexate vs other without methotrexate vs unknown). NIMA match was forced into the model even though not significant.

†

Among patients with hematological malignancies, the other significant predictors in the multivariate models for TRM, overall mortality and treatment failure were patient age (< 10 years vs ≥ 10 years), prior transplant (none vs allogeneic vs autologous vs unknown), pretransplant CMV antibody status (negative vs positive vs unknown) IBMTR risk category (see footnote *), transplant center experience with NYBC CB units (< 50 vs ≥ 50 patients transplanted) and year of transplant (1993-2002 vs 2003-2006). TNC dose (continuous log transformed) was a significant predictor for TRM and overall mortality but not for treatment failure when age was included in the analysis. Patient ethnicity (White vs other vs unknown) was a significant predictor for TRM but not for overall mortality or treatment failure. NIMA match was forced into the models even when not significant.

‡

Among patients with other diseases, TNC dose (continuous log transformed) and prior transplant (none vs allogeneic vsautologous vs unknown) were significant predictors for TRM. NIMA match was forced into the model even though not significant.

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