Outcomes in 257 patients receiving HCT for secondary MDS/t AML (univariate analysis)
| . | Relapse-free survival, 180 events . | Relapse, 69 events . | Nonrelapse mortality, 111 events . | |||
|---|---|---|---|---|---|---|
| HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | |
| Disease stage | .002 | <.001 | .33 | |||
| RA/RARS, n=87 | 1.0 | 1.0 | 1.0 | |||
| RAEB, n=57 | 1.73 (1.1-2.6) | 4.27 (2.0-9.1) | 1.09 (0.6-1.8) | |||
| CMML, n=10 | 1.00 (0.4-2.5) | 1.95 (0.4-8.9) | 0.75 (0.2-2.4) | |||
| tAML untreated, n=29 | 1.89 (1.2-3.1) | 4.40 (1.9-10) | 1.26 (0.7-2.4) | |||
| tAML no response, n=51 | 2.19 (1.4-3.3) | 3.83 (1.7-8.7) | 1.76 (1.1-2.9) | |||
| tAML response, n=23 | 2.12 (1.2-3.7) | 6.67 (2.8-16) | 1.00 (0.4-2.3) | |||
| Therapy of primary disease* | <.001 | <.001 | .14 | |||
| Chemo, n=88 | 1.0 | 1.0 | 1.0 | |||
| Chem/rad, n=72 | 0.87 (0.6-1.2) | 1.17 (0.7-2.0) | 0.70 (0.4-1.1) | |||
| Immuno, n=57 | 0.42 (0.3-0.7) | 0.19 (0.1-0.5) | 0.56 (0.3-0.9) | |||
| HCT, n=32 | 0.69 (0.4-1.1) | 0.63 (0.3-1.5) | 0.73 (0.4-1.4) | |||
| Time from diagnosis to transplantation, mo | .23 | .14 | .02 | |||
| 0 to 6, n=148 | 1.0 | 1.0 | 1.0 | |||
| 7 to 12, n=60 | 0.99 (0.7-1.4) | 1.07 (0.6-1.8) | 0.93 (0.6-1.5) | |||
| 13 to 24, n=29 | 1.63 (1.0-2.5) | 0.98 (0.4-2.3) | 2.10 (1.2-3.6) | |||
| Longer than 24, n=20 | 1.08 (0.6-1.9) | 0.18 (0.0-1.3) | 1.75 (1.0-3.2) | |||
| Cytogenetic risk group† | .008 | <.001 | .56 | |||
| Good, n=70 | 1.0 | 1.0 | 1.0 | |||
| Intermed, n=46 | 1.41 (0.9-2.2) | 2.54 (1.1-5.7) | 1.03 (0.6-1.8) | |||
| Poor, n=123 | 1.77 (1.2-2.6) | 3.33 (1.7-6.7) | 1.26 (0.8-2.0) | |||
| Patient age, y | .001 | .02 | .03 | |||
| Younger than 50, n=170 | 1.0 | 1.0 | 1.0 | |||
| 50 or older, n=87 | 1.65 (1.2-2.2) | 1.80 (1.1-2.9) | 1.56 (1.1-2.3) | |||
| Donor relation | .17 | .46 | .25 | |||
| Related, n=135 | 1.0 | 1.0 | 1.0 | |||
| Unrelated, n=122 | 0.82 (0.6-1.1) | 0.84 (0.5-1.3) | 0.80 (0.6-1.2) | |||
| Stem cell source‡ | .04 | .41 | <.001 | |||
| BM, n=150 | 1.0 | 1.0 | 1.0 | |||
| PBPCs, n=102 | 0.73 (0.5-1.0) | 1.22 (0.8-2.0) | 0.49 (0.3-0.8) | |||
| Conditioning regimen§ | .001 | .08 | <.001 | |||
| High-dose TBI, n=83 | 1.0 | 1.0 | 1.0 | |||
| BUCY, n=29 | 0.77 (0.5-1.2) | 0.30 (0.1-1.0) | 1.00 (0.6-1.7) | |||
| tBUCY, n=93 | 0.46 (0.3-0.7) | 0.72 (0.4-1.3) | 0.33 (0.2-0.5) | |||
| FLutBU, n=12 | 0.76 (0.4-1.6) | 1.64 (0.7-4.1) | 0.29 (0.1-1.2) | |||
| FLuTBI (200), n=26 | 0.62 (0.4-1.1) | 0.62 (0.2-1.6) | 0.62 (0.3-1.2) | |||
| Year of transplantation | .07 | .52 | <.001 | |||
| 2000 to 2006, n=116 | 1.0 | 1.0 | 1.0 | |||
| 1990 to 1999, n=121 | 1.42 (1.0-1.9) | 0.82 (0.5-1.3) | 2.11 (1.4-3.2) | |||
| 1980 to 1989, n=20 | 1.46 (0.8-2.6) | 0.57 (0.2-1.9) | 2.47 (1.3-4.9) | |||
| Acute GVHD, as time-dependent covariate‖ | <.001 | .18 | <.001 | |||
| Grade 0/1, n=83 | 1.0 | 1.0 | 1.0 | |||
| Grade 2, n=99 | 1.07 (0.7-1.6) | 1.33 (0.7-2.4) | 0.89 (0.5-1.5) | |||
| Grade 3/4, n=66 | 2.36 (1.6-3.4) | 1.89 (1.0-3.7) | 2.64 (1.7-4.2) | |||
| Acute GVHD, prior grade, n=143¶ | .005 | .42 | .005 | |||
| Grade 0/1, n=43 | 1.0 | 1.0 | 1.0 | |||
| Grade 2, n=76 | 2.06 (1.1-3.7) | 1.67 (0.7-3.8) | 2.49 (1.1-5.8) | |||
| Grade 3/4, n=24 | 3.00 (1.5-6.1) | 1.70 (0.6-5.2) | 4.53 (1.8-12) | |||
| Primary disease | .02 | <.001 | .29 | |||
| Hematologic malignancy, n=108 | 1.0 | 1.0 | 1.0 | |||
| Nonmalignant hematologic disorder, n=75 | 0.58 (0.4-0.8) | 0.25 (0.1-0.5) | 0.83 (0.5-1.3) | |||
| Solid tumor, n=54 | 0.86 (0.6-1.3) | 1.10 (0.6-1.9) | 0.68 (0.4-1.2) | |||
| Other, n=20 | 1.13 (0.7-1.9) | 0.84 (0.3-2.1) | 1.33 (0.7-2.6) | |||
| . | Relapse-free survival, 180 events . | Relapse, 69 events . | Nonrelapse mortality, 111 events . | |||
|---|---|---|---|---|---|---|
| HR (95% CI) . | P . | HR (95% CI) . | P . | HR (95% CI) . | P . | |
| Disease stage | .002 | <.001 | .33 | |||
| RA/RARS, n=87 | 1.0 | 1.0 | 1.0 | |||
| RAEB, n=57 | 1.73 (1.1-2.6) | 4.27 (2.0-9.1) | 1.09 (0.6-1.8) | |||
| CMML, n=10 | 1.00 (0.4-2.5) | 1.95 (0.4-8.9) | 0.75 (0.2-2.4) | |||
| tAML untreated, n=29 | 1.89 (1.2-3.1) | 4.40 (1.9-10) | 1.26 (0.7-2.4) | |||
| tAML no response, n=51 | 2.19 (1.4-3.3) | 3.83 (1.7-8.7) | 1.76 (1.1-2.9) | |||
| tAML response, n=23 | 2.12 (1.2-3.7) | 6.67 (2.8-16) | 1.00 (0.4-2.3) | |||
| Therapy of primary disease* | <.001 | <.001 | .14 | |||
| Chemo, n=88 | 1.0 | 1.0 | 1.0 | |||
| Chem/rad, n=72 | 0.87 (0.6-1.2) | 1.17 (0.7-2.0) | 0.70 (0.4-1.1) | |||
| Immuno, n=57 | 0.42 (0.3-0.7) | 0.19 (0.1-0.5) | 0.56 (0.3-0.9) | |||
| HCT, n=32 | 0.69 (0.4-1.1) | 0.63 (0.3-1.5) | 0.73 (0.4-1.4) | |||
| Time from diagnosis to transplantation, mo | .23 | .14 | .02 | |||
| 0 to 6, n=148 | 1.0 | 1.0 | 1.0 | |||
| 7 to 12, n=60 | 0.99 (0.7-1.4) | 1.07 (0.6-1.8) | 0.93 (0.6-1.5) | |||
| 13 to 24, n=29 | 1.63 (1.0-2.5) | 0.98 (0.4-2.3) | 2.10 (1.2-3.6) | |||
| Longer than 24, n=20 | 1.08 (0.6-1.9) | 0.18 (0.0-1.3) | 1.75 (1.0-3.2) | |||
| Cytogenetic risk group† | .008 | <.001 | .56 | |||
| Good, n=70 | 1.0 | 1.0 | 1.0 | |||
| Intermed, n=46 | 1.41 (0.9-2.2) | 2.54 (1.1-5.7) | 1.03 (0.6-1.8) | |||
| Poor, n=123 | 1.77 (1.2-2.6) | 3.33 (1.7-6.7) | 1.26 (0.8-2.0) | |||
| Patient age, y | .001 | .02 | .03 | |||
| Younger than 50, n=170 | 1.0 | 1.0 | 1.0 | |||
| 50 or older, n=87 | 1.65 (1.2-2.2) | 1.80 (1.1-2.9) | 1.56 (1.1-2.3) | |||
| Donor relation | .17 | .46 | .25 | |||
| Related, n=135 | 1.0 | 1.0 | 1.0 | |||
| Unrelated, n=122 | 0.82 (0.6-1.1) | 0.84 (0.5-1.3) | 0.80 (0.6-1.2) | |||
| Stem cell source‡ | .04 | .41 | <.001 | |||
| BM, n=150 | 1.0 | 1.0 | 1.0 | |||
| PBPCs, n=102 | 0.73 (0.5-1.0) | 1.22 (0.8-2.0) | 0.49 (0.3-0.8) | |||
| Conditioning regimen§ | .001 | .08 | <.001 | |||
| High-dose TBI, n=83 | 1.0 | 1.0 | 1.0 | |||
| BUCY, n=29 | 0.77 (0.5-1.2) | 0.30 (0.1-1.0) | 1.00 (0.6-1.7) | |||
| tBUCY, n=93 | 0.46 (0.3-0.7) | 0.72 (0.4-1.3) | 0.33 (0.2-0.5) | |||
| FLutBU, n=12 | 0.76 (0.4-1.6) | 1.64 (0.7-4.1) | 0.29 (0.1-1.2) | |||
| FLuTBI (200), n=26 | 0.62 (0.4-1.1) | 0.62 (0.2-1.6) | 0.62 (0.3-1.2) | |||
| Year of transplantation | .07 | .52 | <.001 | |||
| 2000 to 2006, n=116 | 1.0 | 1.0 | 1.0 | |||
| 1990 to 1999, n=121 | 1.42 (1.0-1.9) | 0.82 (0.5-1.3) | 2.11 (1.4-3.2) | |||
| 1980 to 1989, n=20 | 1.46 (0.8-2.6) | 0.57 (0.2-1.9) | 2.47 (1.3-4.9) | |||
| Acute GVHD, as time-dependent covariate‖ | <.001 | .18 | <.001 | |||
| Grade 0/1, n=83 | 1.0 | 1.0 | 1.0 | |||
| Grade 2, n=99 | 1.07 (0.7-1.6) | 1.33 (0.7-2.4) | 0.89 (0.5-1.5) | |||
| Grade 3/4, n=66 | 2.36 (1.6-3.4) | 1.89 (1.0-3.7) | 2.64 (1.7-4.2) | |||
| Acute GVHD, prior grade, n=143¶ | .005 | .42 | .005 | |||
| Grade 0/1, n=43 | 1.0 | 1.0 | 1.0 | |||
| Grade 2, n=76 | 2.06 (1.1-3.7) | 1.67 (0.7-3.8) | 2.49 (1.1-5.8) | |||
| Grade 3/4, n=24 | 3.00 (1.5-6.1) | 1.70 (0.6-5.2) | 4.53 (1.8-12) | |||
| Primary disease | .02 | <.001 | .29 | |||
| Hematologic malignancy, n=108 | 1.0 | 1.0 | 1.0 | |||
| Nonmalignant hematologic disorder, n=75 | 0.58 (0.4-0.8) | 0.25 (0.1-0.5) | 0.83 (0.5-1.3) | |||
| Solid tumor, n=54 | 0.86 (0.6-1.3) | 1.10 (0.6-1.9) | 0.68 (0.4-1.2) | |||
| Other, n=20 | 1.13 (0.7-1.9) | 0.84 (0.3-2.1) | 1.33 (0.7-2.6) | |||
Disease categories and conditioning regimens as per legends to Tables 1 and 3.
HR indicates hazard ratio; CI, confidence interval; chemo, chemotherapy; chem/rad, radiochemotherapy; immuno, immunosuppressive therapy; HCT, hematopoietic cell transplantation; BM, bone marrow; PBPCs, peripheral blood progenitor cells; TBI, total-body irradiation; BU, busulfan; CY, cyclophosphamide; tBU, targeted BU; Flu, fludarabine; GVHD, graft-versus-host disease;
Not available for 8 patients.
Not available for 18 patients.
Excluding 5 patients given cord blood.
Excluding 14 miscellaneous regimens.
Unknown for 9 patients.
Analyzed as a fixed covariate; patients who had developed acute GVHD before day 100.