Characteristics of pediatric patients with AML, ALL, CML, or MDS; T cell–replete BM grafts and myeloablative conditioning regimen, who underwent MSD transplant vs 1-antigen mmRD transplant vs 8/8 matched URD transplant reported to CIBMTR from 1993 to 2006
| Patient characteristic . | MSD . | mmRD . | URD . | P . | ||
|---|---|---|---|---|---|---|
| MSD vs mmRD . | mmRD vs URD . | MSD vs URD . | ||||
| No. of patients | 1208 | 151 | 266 | |||
| Median age, y, (range) | 9 (< 1-17) | 8 (< 1-17) | 9 (< 1-17) | .220 | .099 | .320 |
| Male sex, n (%) | 729 (60) | 96 (64) | 162 (61) | .444 | .589 | .867 |
| Performance score | .335 | .001 | < .001 | |||
| < 90, n (%) | 154 (13) | 25 (17) | 41 (15) | |||
| ≥ 90, n (%) | 1037 (86) | 125 (83) | 199 (75) | |||
| Unknown, n (%) | 17 (1) | 1 (<1) | 26 (10) | |||
| Disease | .004 | .293 | .001 | |||
| AML, n (%) | 447 (37) | 42 (28) | 67 (25) | |||
| ALL, n (%) | 559 (46) | 67 (44) | 136 (51) | |||
| CML, n (%) | 97 (8) | 23 (15) | 26 (10) | |||
| MDS, n (%) | 105 (9) | 19 (13) | 37 (14) | |||
| Disease status* | .144 | .002 | < .001 | |||
| Early, n (%) | 608 (50) | 69 (46) | 76 (29) | |||
| Intermediate, n (%) | 445 (37) | 54 (36) | 134 (50) | |||
| Advanced, n (%) | 155 (13) | 28 (19) | 56 (21) | |||
| TBI use in conditioning | .387 | < .001 | < .001 | |||
| No, n (%) | 565 (47) | 65 (43) | 53 (20) | |||
| Yes, n (%) | 643 (53) | 86 (57) | 213 (80) | |||
| ATG use in conditioning | < .001 | .949 | < .001 | |||
| No, n (%) | 1191 (99) | 123 (81) | 216 (81) | |||
| Yes, n (%) | 17 (1) | 28 (19) | 50 (19) | |||
| GVHD prophylaxis | .004 | .081 | < .001 | |||
| CSA/FK506 ± others (no MTX), n (%) | 258 (21) | 17 (15) | 17 (6) | |||
| MTX ± CSA/FK506, n (%) | 950 (79) | 134 (85) | 249 (94) | |||
| Median time from diagnosis to transplantation, mo (range) | 7 (< 1 to 153) | 8 (1-94) | 14 (< 1 to 115) | .409 | .002 | < .001 |
| Unknown, n (%) | 3 (< 1) | 0 | 0 | |||
| Donor relationship | ||||||
| Sibling, not identical twin, n (%) | 1208 (100) | 43 (28) | 0 | |||
| Parent of recipient, n (%) | 0 | 88 (58) | 0 | |||
| Child of recipient, n (%) | 0 | 2 (1) | 0 | |||
| Other relative, n (%) | 0 | 18 (12) | 0 | |||
| Unrelated, n (%) | 0 | 0 | 266 (100) | |||
| Donor/recipient sex match | .584 | .001 | < .001 | |||
| Male/male, n (%) | 378 (31) | 47 (31) | 119 (45) | |||
| Male/female, n (%) | 254 (21) | 25 (17) | 58 (22) | |||
| Female/male, n (%) | 351 (29) | 49 (32) | 43 (16) | |||
| Female/female, n (%) | 225 (19) | 30 (20) | 46 (17) | |||
| Donor/recipient CMV match | .001 | < .001 | < .001 | |||
| −/−, n (%) | 382 (32) | 38 (25) | 122 (46) | |||
| −/+, n (%) | 170 (14) | 18 (12) | 52 (20) | |||
| +/−, n (%) | 115 (10) | 30 (20) | 43 (16) | |||
| +/+, n (%) | 500 (41) | 56 (37) | 46 (17) | |||
| Unknown, n (%) | 41 (3) | 9 (6) | 3 (1) | |||
| Median donor age, y, (range) | 10 (< 1 to 45) | 31 (< 1 to 66) | 36 (19-57) | < .001 | < .001 | < .001 |
| Unknown, n (%) | 12 (1) | 4 (3) | 0 | |||
| Year of transplantation | .375 | < .001 | < .001 | |||
| 1993-1999 | 912 (75) | 109 (72) | 119 (45) | |||
| 2000-2006 | 296 (25) | 42 (28) | 147 (55) | |||
| Median follow-up of survivors, mo (range) | 79 (2-171) | 62 (3-177) | 61 (12-168) | |||
| Region of transplant center | ||||||
| United States, n (%) | 316 (26) | 49 (32) | 261 (98) | |||
| Canada, n (%) | 89 (7) | 15 (10) | 0 | |||
| Europe, n (%) | 251 (21) | 27 (18) | 4 (2) | |||
| Asia, n (%) | 53 (4) | 8 (5) | 0 | |||
| Australia/New Zealand, n (%) | 135 (11) | 20 (13) | 0 | |||
| Mideast/Africa, n (%) | 290 (24) | 17 (11) | 0 | |||
| Central/South America, n (%) | 74 (6) | 15 (10) | 1 (< 1) | |||
| Patient characteristic . | MSD . | mmRD . | URD . | P . | ||
|---|---|---|---|---|---|---|
| MSD vs mmRD . | mmRD vs URD . | MSD vs URD . | ||||
| No. of patients | 1208 | 151 | 266 | |||
| Median age, y, (range) | 9 (< 1-17) | 8 (< 1-17) | 9 (< 1-17) | .220 | .099 | .320 |
| Male sex, n (%) | 729 (60) | 96 (64) | 162 (61) | .444 | .589 | .867 |
| Performance score | .335 | .001 | < .001 | |||
| < 90, n (%) | 154 (13) | 25 (17) | 41 (15) | |||
| ≥ 90, n (%) | 1037 (86) | 125 (83) | 199 (75) | |||
| Unknown, n (%) | 17 (1) | 1 (<1) | 26 (10) | |||
| Disease | .004 | .293 | .001 | |||
| AML, n (%) | 447 (37) | 42 (28) | 67 (25) | |||
| ALL, n (%) | 559 (46) | 67 (44) | 136 (51) | |||
| CML, n (%) | 97 (8) | 23 (15) | 26 (10) | |||
| MDS, n (%) | 105 (9) | 19 (13) | 37 (14) | |||
| Disease status* | .144 | .002 | < .001 | |||
| Early, n (%) | 608 (50) | 69 (46) | 76 (29) | |||
| Intermediate, n (%) | 445 (37) | 54 (36) | 134 (50) | |||
| Advanced, n (%) | 155 (13) | 28 (19) | 56 (21) | |||
| TBI use in conditioning | .387 | < .001 | < .001 | |||
| No, n (%) | 565 (47) | 65 (43) | 53 (20) | |||
| Yes, n (%) | 643 (53) | 86 (57) | 213 (80) | |||
| ATG use in conditioning | < .001 | .949 | < .001 | |||
| No, n (%) | 1191 (99) | 123 (81) | 216 (81) | |||
| Yes, n (%) | 17 (1) | 28 (19) | 50 (19) | |||
| GVHD prophylaxis | .004 | .081 | < .001 | |||
| CSA/FK506 ± others (no MTX), n (%) | 258 (21) | 17 (15) | 17 (6) | |||
| MTX ± CSA/FK506, n (%) | 950 (79) | 134 (85) | 249 (94) | |||
| Median time from diagnosis to transplantation, mo (range) | 7 (< 1 to 153) | 8 (1-94) | 14 (< 1 to 115) | .409 | .002 | < .001 |
| Unknown, n (%) | 3 (< 1) | 0 | 0 | |||
| Donor relationship | ||||||
| Sibling, not identical twin, n (%) | 1208 (100) | 43 (28) | 0 | |||
| Parent of recipient, n (%) | 0 | 88 (58) | 0 | |||
| Child of recipient, n (%) | 0 | 2 (1) | 0 | |||
| Other relative, n (%) | 0 | 18 (12) | 0 | |||
| Unrelated, n (%) | 0 | 0 | 266 (100) | |||
| Donor/recipient sex match | .584 | .001 | < .001 | |||
| Male/male, n (%) | 378 (31) | 47 (31) | 119 (45) | |||
| Male/female, n (%) | 254 (21) | 25 (17) | 58 (22) | |||
| Female/male, n (%) | 351 (29) | 49 (32) | 43 (16) | |||
| Female/female, n (%) | 225 (19) | 30 (20) | 46 (17) | |||
| Donor/recipient CMV match | .001 | < .001 | < .001 | |||
| −/−, n (%) | 382 (32) | 38 (25) | 122 (46) | |||
| −/+, n (%) | 170 (14) | 18 (12) | 52 (20) | |||
| +/−, n (%) | 115 (10) | 30 (20) | 43 (16) | |||
| +/+, n (%) | 500 (41) | 56 (37) | 46 (17) | |||
| Unknown, n (%) | 41 (3) | 9 (6) | 3 (1) | |||
| Median donor age, y, (range) | 10 (< 1 to 45) | 31 (< 1 to 66) | 36 (19-57) | < .001 | < .001 | < .001 |
| Unknown, n (%) | 12 (1) | 4 (3) | 0 | |||
| Year of transplantation | .375 | < .001 | < .001 | |||
| 1993-1999 | 912 (75) | 109 (72) | 119 (45) | |||
| 2000-2006 | 296 (25) | 42 (28) | 147 (55) | |||
| Median follow-up of survivors, mo (range) | 79 (2-171) | 62 (3-177) | 61 (12-168) | |||
| Region of transplant center | ||||||
| United States, n (%) | 316 (26) | 49 (32) | 261 (98) | |||
| Canada, n (%) | 89 (7) | 15 (10) | 0 | |||
| Europe, n (%) | 251 (21) | 27 (18) | 4 (2) | |||
| Asia, n (%) | 53 (4) | 8 (5) | 0 | |||
| Australia/New Zealand, n (%) | 135 (11) | 20 (13) | 0 | |||
| Mideast/Africa, n (%) | 290 (24) | 17 (11) | 0 | |||
| Central/South America, n (%) | 74 (6) | 15 (10) | 1 (< 1) | |||
MDS indicates matched sibling donor; mmRD, mismatch related donor/phenotypically matched donor; URD, unrelated donor; CIBMTR, Center for International Blood and Marrow Transplant Research; AML, acute myelogenous leukemia; ALL, acute lymphoblastic leukemia; CML, chronic myelogenous leukemia; MDS, myelodysplastic syndrome; TBI, total body irradiation; ATG, antithymocyte globulin; GVHD, graft-versus-host disease; CSA, cyclosporine; FK506, tacrolimus; MTX, methotrexate; and CMV, cytomegalovirus.
Early disease is defined as patients with ALL and AML in first complete remission, CML in first chronic phase and myelodysplasia with refractory anemia or acquired idiopathic sideroblastic anemia. Intermediate is defined as ALL and AML in second or greater complete remission, CML in accelerated phase or second or greater chronic phase; and advanced is defined as primary induction failure of ALL and AML, blastic phase of CML, relapse, refractory anemia with excess blasts, refractory anemia with excess blasts in transformation, chronic myelomonocytic leukemia and juvenile myelomonocytic leukemia.