Background
Methods
Data collection
Statistical analyses
Results
Patient, disease, and transplant characteristics
sCBT (n = 172) | dCBT (n = 362) |
P valuea
| |
---|---|---|---|
Median patient age, months (range) | 50 (18–68) | 52 (18–76) | 0.17 |
Median follow-up, months (range) | 54 (1–118) | 34 (2–98) | <0.001 |
Year of transplantation, median (range) | 2008 (2004–2014) | 2010 (2005–2014) | <0.001 |
Recipient sex M, no. (%) | 71 (41) | 201 (56) | 0.002 |
Recipient weight, median (range) | 64 | 70 | <0.001 |
Time from diagnosis to CBT (months), median (range) | |||
CR1 | 6 (3–70) | 6 (2–147) | 0. 7 |
CR2 | 22 (4–95) | 22 (6–209) | 0.7 |
Disease, no. (%) | |||
Acute myeloid leukemia | 131 (76) | 277 (76) | 0.9 |
Acute lymphoblastic leukemia | 41 (24) | 85 (24) | |
Donor CMV seropositive, no. (%) | 107 (65) | 222 (64) | 0.92 |
Status at transplantation, no. (%) | |||
CR1 | 91 (53) | 207 (57) | 0.6 |
CR2 | 72 (42) | 139 (38) | |
CR3 | 9 (5) | 16 (4) | |
Cytogenetics, no. (%) | 0.85 | ||
Acute myeloid leukemia | |||
Good riskb
| 7 (5) | 21 (8) | |
Intermediate riskc
| 82 (62) | 172 (62) | |
High riskd
| 20 (15) | 33 (12) | |
Not reported/failed | 22 (17) | 51 (18) | |
Acute lymphoblastic leukemia | |||
Intermediate riske
| 15 (37) | 31 (36) | |
High riskf
| 18 (44) | 38 (45) | |
Not reported/failed | 8 (19) | 16 (19) | |
Conditioning regimen, no. (%) | <0.001 | ||
TCF | 113 (66) | 300 (83) | |
TBF | 19 (11) | 5 (1) | |
TTBF | 9 (5) | 0 | |
FM+/−C | 3 (2) | 12 (3) | |
CF+/−T | 9 (5) | 5 (1) | |
Other | 19 (11) | 38 (10) | |
Missing | 0 | 2 (0.5) | |
Recipient CMV-seronegative, no. (%) | 57 (35) | 123 (36) | 0.9 |
ATG, no. (%) | 61 (37) | 51 (16) | <0.001 |
Postgrafting immunosuppression, no. (%) | |||
CNI + MMF | 121 (70) | 327 (90) | <0.001 |
CNI + Pred | 21 (12) | 4 (1) | |
CNI + Mtx | 10 (6) | 9 (2) | |
CNI alone | 10 (6) | 11 (3) | |
Other | 10 (6) | 11 (3) |
sCBT (n = 172) | dCBT (n = 362) |
P value1
| |
---|---|---|---|
Number of HLA disparities, no. (%) | |||
0–1 Mismatch | 55 (32) | 79 (22) | 0.13 |
2 Mismatches | 99 (58) | 192 (53) | |
3–4 Mismatches | 9 (5) | 24 (7) | |
Missing data | 9 (5) | 67 (18) | |
ABO group, no. (%) | 0.08 | ||
Compatible or minor mismatch | 89 (52) | 159 (44) | |
Major mismatch | 53 (31) | 139 (38) | |
Missing data | 30 (17) | 64 (18) | |
TNC at collection × 107/kg | |||
Median (range) | 3.8 (2.5–9.0) | 5.1 (1.5–13.7)a
| <0.001 |
CD34+ cell at collection × 105/kg | |||
Median (range) | 3.1 (0.6–6.8) | 4.0 (0.4–10.4) | 0.003 |
TNC at infusion × 107/kg | |||
Median (range) | 3.1 (0.6–6.8) | 4 (0.4–10.4) | <0.001 |
CD34+ cell at infusion × 105/kg | |||
Median (range) | 1.2 (0.2–4.9) | 1.2 (0.1–8.5) | 0.5 |
Engraftment and GVHD
Relapse, NRM, GRFS LFS, and OS
Hazard ratio | 95% confidence interval |
P value | ||
---|---|---|---|---|
Lower limit | Upper limit | |||
Relapse | 0.90 | 0.63 | 1.27 | 0.54 |
Nonrelapse mortality | 0.81 | 0.54 | 1.22 | 0.32 |
Leukemia-free survival | 0.84 | 0.65 | 1.10 | 0.20 |
GVHD-free relapse-free survival | 1.0 | 0.9 | 1.0 | 0.34 |
Overall survival | 0.83 | 0.63 | 1.09 | 0.17 |
sCBT (n = 29) | dCBT (n = 59) | |
---|---|---|
Relapse or disease progression | 6 (20.7) | 13 (22.4) |
GvHD | 3 (10.3) | 13 (22.4) |
Idiopathic pneumonia syndrome | 1 (3.4) | 2 (3.4) |
Hemorrhage | 1 (3.4) | 1 (1.7) |
Rejection | 0 (0.0) | 1 (1.7) |
Bacterial infection | 3 (10.3) | 8 (13.8) |
Viral infection | 0 (0.0) | 3 (5.2) |
Fungal infection | 1 (3.4) | 4 (6.9) |
Unknown infection | 9 (31.0) | 7 (12.1) |
Cardiac toxicity | 0 (0.0) | 1 (1.7) |
ARDS | 1 (3.4) | 0 (0.0) |
Secondary malignancy | 1 (3.4) | 0 (0.0) |
Multiorgan failure | 0 (0.0) | 1 (1.7) |
LPTD EBV | 0 (0.0) | 0 (0.0) |
Other | 3 (10.3) | 4 (6.9) |
Missing | 0 | 1 |
Subgroup analyses
Impact of cell dose
Hazard ratio | 95% confidence interval |
P value | ||
---|---|---|---|---|
Lower limit | Upper limit | |||
Relapse | ||||
sCBT and TNC > median (ref) | – | – | – | – |
dCBT and TNC > median | 1.32 | 0.67 | 2.58 | 0.42 |
sCBT and TNC < median | 1.99 | 1.02 | 3.89 | 0.04 |
dCBT and TNC < median | 1.74 | 0.88 | 3.43 | 0.11 |
Nonrelapse mortality | ||||
sCBT and TNC > median (ref) | – | – | – | – |
dCBT and TNC > median | 0.69 | 0.35 | 1.36 | 0.29 |
sCBT and TNC < median | 1.01 | 0.53 | 1.93 | 0.97 |
dCBT and TNC < median | 0.93 | 0.47 | 1.83 | 0.84 |
Leukemia-free survival | ||||
sCBT and TNC > median (ref) | – | – | – | – |
dCBT and TNC > median | 0.97 | 0.61 | 1.55 | 0.89 |
sCBT and TNC < median | 1.46 | 0.92 | 2.30 | 0.11 |
dCBT and TNC < median | 1.27 | 0.79 | 2.03 | 0.33 |
Overall survival | ||||
sCBT and TNC > median (ref) | – | – | – | – |
dCBT and TNC > median | 0.97 | 0.60 | 1.58 | 0.91 |
sCBT and TNC < median | 1.39 | 0.86 | 2.23 | 0.18 |
dCBT and TNC < median | 1.07 | 0.65 | 1.77 | 0.78 |