Univariate regression model for relapse
| Variable . | Group . | HR . | 95% CI . | P . | Global P . |
|---|---|---|---|---|---|
| Marrow myeloblasts* | 1.02 | 1.01-1.03 | < .0001 | ||
| Hemoglobin* | 0.96 | 0.89-1.04 | .31 | ||
| Platelet count* | 0.98 | 0.95-1.03 | .50 | ||
| Patient age* | 1.10 | 1.02-1.19 | .01 | ||
| Disease category | MDS | 1 | |||
| tAML | 2.51 | 1.96-3.22 | < .0001 | ||
| IPSS cytogenetic risk | Good | 1 | < .0001 | ||
| Intermediate | 1.10 | 0.75-1.62 | .62 | ||
| Poor | 2.76 | 2.08-3.66 | < .0001 | ||
| 5-group cytogenetic risk | Good | 1 | < .0001 | ||
| Very good | 0.82 | 0.20-3.34 | .78 | ||
| Intermediate | 1.23 | 0.84-1.80 | .28 | ||
| Poor | 1.74 | 1.21-2.51 | .003 | ||
| Very poor | 6.68 | 4.67-9.56 | < .0001 | ||
| Data incomplete | 1.72 | 1.15-2.55 | .008 | ||
| Donor type | Matched sibling | 1 | .15 | ||
| Nonsibling relative | 0.69 | 0.39-1.22 | .20 | ||
| URD matched | 0.76 | 0.56-1.02 | .07 | ||
| URD mismatched | 0.83 | 0.58-1.21 | .34 | ||
| URD unknown | 0.46 | 0.19-1.11 | .09 | ||
| Year of HCT* | 1.02 | 1.00-1.04 | .03 | ||
| Monosomal karyotype | No | 1 | |||
| Yes | 3.70 | 2.78-4.92 | < .0001 | ||
| Secondary MDS | No | 1 | |||
| Yes | 1.27 | 0.95-1.68 | .10 | ||
| Conditioning regimen† | BU + CY | 1 | .001 | ||
| FLU + LD TBI | 2.38 | 1.64-3.45 | < .0001 | ||
| FLU + BU | 2.03 | 1.21-3.41 | .008 | ||
| 131I + FLU + TBI | 2.34 | 1.18-4.64 | .02 | ||
| FLU + TREO | 0.39 | 0.10-1.59 | .19 | ||
| CY + TBI (≥ 12 Gy) (± ATG) | 1.56 | 1.12-2.18 | .009 | ||
| FAB/WHO classification | RA/RARS/RCMD | 1 | < .0001 | ||
| RAEB. | 2.09 | 1.56-2.79 | < .0001 | ||
| RAEB-T | 2.18 | 1.41-3.37 | .0005 | ||
| tAML | 2.70 | 1.82-3.99 | < .0001 | ||
| Etiology‡ | de novo | 1 | .002 | ||
| Aplastic anemia | 0.26 | 0.10-0.70 | .008 | ||
| Lymphoma | 1.70 | 1.09-2.67 | .02 | ||
| Solid tumor | 1.92 | 1.22-3.01 | .005 | ||
| Other leukemias | 2.57 | 1.31-5.01 | .006 | ||
| Treatment pre-HCT | None | 1 | < .0001 | ||
| IC | 2.09 | 1.61-2.71 | < .0001 | ||
| IC + hypomethylation | 0.00 | 0.00-**** | .97 | ||
| Hypomethylation | 2.53 | 1.51-4.23 | .0004 |
| Variable . | Group . | HR . | 95% CI . | P . | Global P . |
|---|---|---|---|---|---|
| Marrow myeloblasts* | 1.02 | 1.01-1.03 | < .0001 | ||
| Hemoglobin* | 0.96 | 0.89-1.04 | .31 | ||
| Platelet count* | 0.98 | 0.95-1.03 | .50 | ||
| Patient age* | 1.10 | 1.02-1.19 | .01 | ||
| Disease category | MDS | 1 | |||
| tAML | 2.51 | 1.96-3.22 | < .0001 | ||
| IPSS cytogenetic risk | Good | 1 | < .0001 | ||
| Intermediate | 1.10 | 0.75-1.62 | .62 | ||
| Poor | 2.76 | 2.08-3.66 | < .0001 | ||
| 5-group cytogenetic risk | Good | 1 | < .0001 | ||
| Very good | 0.82 | 0.20-3.34 | .78 | ||
| Intermediate | 1.23 | 0.84-1.80 | .28 | ||
| Poor | 1.74 | 1.21-2.51 | .003 | ||
| Very poor | 6.68 | 4.67-9.56 | < .0001 | ||
| Data incomplete | 1.72 | 1.15-2.55 | .008 | ||
| Donor type | Matched sibling | 1 | .15 | ||
| Nonsibling relative | 0.69 | 0.39-1.22 | .20 | ||
| URD matched | 0.76 | 0.56-1.02 | .07 | ||
| URD mismatched | 0.83 | 0.58-1.21 | .34 | ||
| URD unknown | 0.46 | 0.19-1.11 | .09 | ||
| Year of HCT* | 1.02 | 1.00-1.04 | .03 | ||
| Monosomal karyotype | No | 1 | |||
| Yes | 3.70 | 2.78-4.92 | < .0001 | ||
| Secondary MDS | No | 1 | |||
| Yes | 1.27 | 0.95-1.68 | .10 | ||
| Conditioning regimen† | BU + CY | 1 | .001 | ||
| FLU + LD TBI | 2.38 | 1.64-3.45 | < .0001 | ||
| FLU + BU | 2.03 | 1.21-3.41 | .008 | ||
| 131I + FLU + TBI | 2.34 | 1.18-4.64 | .02 | ||
| FLU + TREO | 0.39 | 0.10-1.59 | .19 | ||
| CY + TBI (≥ 12 Gy) (± ATG) | 1.56 | 1.12-2.18 | .009 | ||
| FAB/WHO classification | RA/RARS/RCMD | 1 | < .0001 | ||
| RAEB. | 2.09 | 1.56-2.79 | < .0001 | ||
| RAEB-T | 2.18 | 1.41-3.37 | .0005 | ||
| tAML | 2.70 | 1.82-3.99 | < .0001 | ||
| Etiology‡ | de novo | 1 | .002 | ||
| Aplastic anemia | 0.26 | 0.10-0.70 | .008 | ||
| Lymphoma | 1.70 | 1.09-2.67 | .02 | ||
| Solid tumor | 1.92 | 1.22-3.01 | .005 | ||
| Other leukemias | 2.57 | 1.31-5.01 | .006 | ||
| Treatment pre-HCT | None | 1 | < .0001 | ||
| IC | 2.09 | 1.61-2.71 | < .0001 | ||
| IC + hypomethylation | 0.00 | 0.00-**** | .97 | ||
| Hypomethylation | 2.53 | 1.51-4.23 | .0004 |
CMV status and source of stem cells had no significant impact on outcome.
URD indicates unrelated donor; and ATG, antithymocyte globulin.
Modeled as continuous linear variables; HR for platelet count represents increase in hazard associated with increase in platelets by 50 000; HR for age represents increase in hazard associated with increase in age by 10 years; HR for year of HCT represents increase in hazard associated with increase in year of HCT by one year; HR for hemoglobin represents increase in hazard associated with increase in hemoglobin by 1 g/dL; HR for blasts represents increase in hazard associated with increase in blasts by 1%.
Other regimens used (CY + TMI; FLU + TBI + CY; CY + BU; BU + TBI; BU + CY + TBI; other regimens) did not result in a significant differences.
Other antecedent conditions (myeloproliferative neoplasms; constitutional marrow failure syndromes; multiple myeloma; autoimmune disoders; prior solid organ transplantation or accidental radiation exposure) had no significant impact.