Patient and transplantation characteristics after allogeneic HSCT and conventional or nonmyeloablative conditioning
Factors . | Conventional; n = 917 . | Nonmyeloablative; n = 183 . | P . |
---|---|---|---|
Median patient age, y (range) | 41 (1-66) | 53 (1-73) | .001 |
Male/female | 504/413 | 115/68 | .051 |
Prior transplantation (%) | .001 | ||
Yes | 20 (2) | 56 (31) | |
No | 897 (98) | 127 (69) | |
Underlying diagnosis (%) | .001 | ||
CML | 316 (34) | 15 (8) | |
Acute leukemia/MDS | 513 (56) | 52 (28) | |
Other malignancy | 60 (7) | 108 (59) | |
Lymphoma/CLL | 45 | 59 | |
Multiple myeloma | 8 | 34 | |
Other tumors* | 7 | 15 | |
Nonmalignant disease | 28 (3) | 8 (4) | |
Aplastic anemia | 14 | — | |
Immunodeficiencies | 2 | 7 | |
Other diseases* | 12 | 1 | |
Disease risk (%)† | .001 | ||
Low | 623 (68) | 89 (49) | |
High | 294 (32) | 94 (51) | |
Conditioning (%) | NE | ||
TBI-based, more than 12 Gy | 273 (30) | — | |
TBI-based, 12 Gy | 256 (28) | — | |
Non-TBI-based, 0 Gy | 388 (42) | — | |
2 Gy TBI | — | 56 (31) | |
2 Gy TBI + fludarabine | — | 127 (69) | |
Donor (%) | .001 | ||
HLA-matched related | 429 (47) | 120 (66) | |
HLA-mismatched related | 55 (6) | — | |
Unrelated | 433 (47) | 63 (34) | |
Stem cell source (%)‡ | .001 | ||
PBSC | 317 (35) | 166 (91) | |
Bone marrow | 600 (65) | 17 (9) | |
Recipient CMV serostatus (%) | .035 | ||
Positive | 446 (49) | 105 (57) | |
Negative | 471 (51) | 78 (43) | |
Donor CMV status (%) | NS | ||
Positive | 371 (40) | 86 (47) | |
Negative | 546 (60) | 97 (53) | |
GVHD prophylaxis (%)§ | NE | ||
MTX-containing regimens | 877 (96) | — | |
Others | 40 (4) | 183 (100) |
Factors . | Conventional; n = 917 . | Nonmyeloablative; n = 183 . | P . |
---|---|---|---|
Median patient age, y (range) | 41 (1-66) | 53 (1-73) | .001 |
Male/female | 504/413 | 115/68 | .051 |
Prior transplantation (%) | .001 | ||
Yes | 20 (2) | 56 (31) | |
No | 897 (98) | 127 (69) | |
Underlying diagnosis (%) | .001 | ||
CML | 316 (34) | 15 (8) | |
Acute leukemia/MDS | 513 (56) | 52 (28) | |
Other malignancy | 60 (7) | 108 (59) | |
Lymphoma/CLL | 45 | 59 | |
Multiple myeloma | 8 | 34 | |
Other tumors* | 7 | 15 | |
Nonmalignant disease | 28 (3) | 8 (4) | |
Aplastic anemia | 14 | — | |
Immunodeficiencies | 2 | 7 | |
Other diseases* | 12 | 1 | |
Disease risk (%)† | .001 | ||
Low | 623 (68) | 89 (49) | |
High | 294 (32) | 94 (51) | |
Conditioning (%) | NE | ||
TBI-based, more than 12 Gy | 273 (30) | — | |
TBI-based, 12 Gy | 256 (28) | — | |
Non-TBI-based, 0 Gy | 388 (42) | — | |
2 Gy TBI | — | 56 (31) | |
2 Gy TBI + fludarabine | — | 127 (69) | |
Donor (%) | .001 | ||
HLA-matched related | 429 (47) | 120 (66) | |
HLA-mismatched related | 55 (6) | — | |
Unrelated | 433 (47) | 63 (34) | |
Stem cell source (%)‡ | .001 | ||
PBSC | 317 (35) | 166 (91) | |
Bone marrow | 600 (65) | 17 (9) | |
Recipient CMV serostatus (%) | .035 | ||
Positive | 446 (49) | 105 (57) | |
Negative | 471 (51) | 78 (43) | |
Donor CMV status (%) | NS | ||
Positive | 371 (40) | 86 (47) | |
Negative | 546 (60) | 97 (53) | |
GVHD prophylaxis (%)§ | NE | ||
MTX-containing regimens | 877 (96) | — | |
Others | 40 (4) | 183 (100) |
Numbers of patients (% of the total) are shown for all categories except patient age and patient sex. AML indicates acute myeloid leukemia; ALL, acute lymphocytic leukemia; HD, Hodgkin disease; NHL, non-Hodgkin lymphoma; CLL, chronic lymphocytic leukemia; MM, multiple myeloma; —, not applicable; NE, not evaluable; and NS, not statistically significant.
Other tumors include renal cell carcinoma. Other diseases include paroxysmal nocturnal hemoglobinuria.
Patients were stratified based on underlying disease, as described previously.31 High risk was defined as active, de novo, or relapsed AML, MDS (refractory anemia with excess blasts or excess blasts in transformation), myeloproliferative disorder, ALL, CLL, NHL, HD, MM regardless of status, accelerated phase or blastic crisis of CML, or other tumors such as renal cell carcinoma. Low risk was defined as nonmalignant disease, including aplastic anemia, immunodeficiency syndrome, any of the diseases mentioned with unknown disease status or in remission except for MM, CML chronic phase, and MDS (refractory anemia with or without ringed sideroblasts).
The PBSC group included 6 patients who received PBSCs and bone marrow.
After nonmyeloablative transplantation, all patients were given MMF and CSP. After conventional transplantation, most patients were given MTX and CSP, and others received MMF and CSP (n = 31) or CSP and anti-T-cell antibodies (n = 9).