Background
Methods
Study design
Statistical analysis
Results
Patients, disease, and transplant characteristics
Variables | ||
---|---|---|
Follow-up (months) | Median (range) | 31 (2–79) |
Patient age (years) | Median (range) | 32 (18–76) |
Year of Tx | Median (range) | 2012 (2007–2014) |
Patient sex | Female | 80 (39%) |
Male | 127 (61%) | |
Karnofsky at Tx | ≥90% | 128 (69%) |
Previous autologous Tx | Yes | 14 (7%) |
Disease status at Tx | CR1 | 91 (44%) |
CR2+ | 58 (28%) | |
Advanced disease | 59 (28%) | |
Immunophenotype | B ALL | 100 (66%) |
T ALL | 51 (34%) | |
CNS involvement | Yes | 10 (10%) |
Status of MRD at Tx | Positive | 45 (49%) |
Negative | 46 (51%) | |
Cytogenetics | Ph-positive | 46 (32%) |
Ph-negative | 96 (68%) | |
Normal karyotype
|
37
| |
Abnormal karyotype
|
32
| |
t(4;11) |
4
| |
t(1;19) |
5
| |
t(12;21) |
2
| |
Donor age |
Median (range) | 39 (12–74) |
F donor/M recipient | Yes | 63 (30%) |
Stem cell source | BM | 89 (43%) |
PB | 119 (57%) | |
CMV D/R | Neg to neg | 24 (12%) |
Pos to neg | 20 (10%) | |
Neg to pos | 30 (15%) | |
Pos to pos | 127 (63%) | |
Donor kinship | Parents | 49 (37%) |
Sibling | 51 (38%) | |
Child | 25 (19%) | |
Others relatives | 8 (6%) | |
Conditioning regimen | MAC |
137 (66%) |
TBI-based (8–12 Gy) | 63 | |
Cy TBI
|
29
| |
Flu TBI
|
31
| |
Other TBI
|
3
| |
Chemo-based | 74 | |
TBF
|
38
| |
Bu Cy
|
1
| |
Bu Flu
|
3
| |
Flu Mel
|
2
| |
Treo-based
|
5
| |
Cy Flu
|
5
| |
Cy AraC Bu
|
19
| |
Cy Ida
|
1
| |
RIC |
71 (34%) | |
TBI based (<6 Gy) |
26
| |
Cy TBI
|
15
| |
Flu TBI
|
11
| |
Chemo-based |
45
| |
TBF
|
8
| |
Bu Flu
|
4
| |
Bu ± others
|
1
| |
Flu Mel
|
6
| |
Bu Mel
|
1
| |
Treo-based
|
11
| |
Cy Flu
|
11
| |
Cy thiotepa Bu
|
1
| |
Cy AraC Bu
|
1
| |
GVHD prophylaxis | PT-Cy | 118 (57%) |
ATG-based | 90 (43%) |
Engraftment and graft-versus-host-disease
HR | CI |
p
| |
---|---|---|---|
Relapse | |||
Age (per 10 years) | 0.95 | 0.744–1.217 | 0.69 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 1.69 | 0.72–3.95 | 0.22 |
Advanced | 8.04 | 3.76–17.19 |
<0.01
|
Ph+ vs Ph− | 1.09 | 0.53–2.24 | 0.80 |
KPS ≥ 90% | 2.02 | 0.95–4.29 | 0.06 |
Female recipient | 0.59 | 0.29–1.20 | 0.14 |
Female D ≥ male R | 0.39 | 0.18–0.84 |
0.01
|
RIC vs MAC | 1.32 | 0.67–2.5 | 0.41 |
R CMV positive | 1.11 | 0.45–2.75 | 0.81 |
ATG vs PT-Cy | 1.15 | 0.63–2.13 | 0.63 |
PB vs BM | 1.46 | 0.68–3.10 | 0.32 |
Center (frailty) | 0.94 | ||
NRM | |||
Age (per 10 years) | 0.98 | 0.72–1.33 | 0.90 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 2.15 | 0.92–5.02 | 0.07 |
Advanced | 1.50 | 0.59–3.82 | 0.39 |
Ph+ vs Ph− | 1.45 | 0.61–3.42 | 0.39 |
KPS ≥ 90% | 0.23 | 0.10–0.52 |
<0.01
|
Female recipient | 1.26 | 0.52–3.04 | 0.59 |
Female D ≥ male R | 1.47 | 0.60–3.57 | 0.39 |
RIC vs MAC | 0.76 | 0.36–1.60 | 0.47 |
R CMV positive | 0.57 | 0.23–1.41 | 0.22 |
ATG vs PT-Cy | 1.79 | 0.90–3.55 | 0.09 |
PB vs BM | 2.56 | 1.14–5.74 |
0.02
|
Center (frailty) | 0.94 | ||
LFS | |||
Age (per 10 years) | 0.98 | 0.82–1.18 | 0.89 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 1.91 | 1.06–3.41 |
0.02
|
Advanced | 3.81 | 2.17–6.67 |
<0.01
|
Ph + vs Ph− | 1.13 | 0.66–1.94 | 0.63 |
KPS ≥ 90% | 0.78 | 0.47–1.29 | 0.34 |
Female recipient | 0.77 | 0.45–1.32 | 0.35 |
Female D ≥ male R | 0.72 | 0.41–1.24 | 0.24 |
RIC vs MAC | 1.05 | 0.64–1.72 | 0.82 |
R CMV positive | 0.73 | 0.40–1.33 | 0.31 |
ATG vs PT-Cy | 1.32 | 0.84–2.06 | 0.21 |
PB vs BM | 1.81 | 1.06–3.09 |
0.02
|
Center (frailty) | 0.9 | ||
OS | |||
Age (per 10 years) | 1.02 | 0.84–1.22 | 0.82 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 2.22 | 1.22–4.03 |
<0.01
|
Advanced | 3.66 | 2.06–6.52 |
<0.01
|
Ph + vs Ph− | 1.16 | 0.67–2.01 | 0.58 |
KPS ≥ 90% | 0.62 | 0.37–1.02 | 0.06 |
Female recipient | 0.81 | 0.47–1.38 | 0.44 |
Female D ≥ male R | 0.76 | 0.43–1.35 | 0.36 |
RIC vs MAC | 0.91 | 0.56–1.48 | 0.71 |
R CMV positive | 0.81 | 0.43–1.51 | 0.51 |
ATG vs PT-Cy | 1.4 | 0.88–2.20 | 0.14 |
PB vs BM | 1.98 | 1.14–3.42 |
0.01
|
Center (frailty) | 0.92 | ||
GRFS | |||
Age (per 10 years) | 0.91 | 0.76–1.08 | 0.29 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 1.35 | 0.78–2.34 | 0.28 |
Advanced | 2.71 | 1.56–4.68 |
<
0.01
|
Ph + vs Ph− | 1.20 | 0.72–2.02 | 0.47 |
KPS ≥ 90% | 0.84 | 0.50–1.40 | 0.51 |
Female recipient | 0.70 | 0.42–1.18 | 0.18 |
Female D ≥ male R | 0.81 | 0.48–1.38 | 0.45 |
RIC vs MAC | 1.03 | 0.65–1.63 | 0.87 |
R CMV positive | 0.85 | 0.47–1.53 | 0.59 |
ATG vs PT-Cy | 1.04 | 0.67–1.61 | 0.85 |
PB vs BM | 1.82 | 1.10–3.01 |
0.01
|
Center (frailty) | 0.92 | ||
aGVHD II-IV | |||
Age (per 10 years) | 0.75 | 0.56–1.00 | 0.05 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 1.45 | 0.696–3.024 | 0.32 |
Advanced | 0.76 | 0.29–2.0 | 0.59 |
Ph + vs Ph− | 1.15 | 0.52–2.55 | 0.72 |
KPS ≥ 90% | 0.80 | 0.33–1.93 | 0.63 |
Female recipient | 1.23 | 0.53–2.88 | 0.62 |
Female D ≥ male R | 1.84 | 0.82–4.13 | 0.13 |
RIC vs MAC | 0.46 | 0.23–0.93 | 0.03 |
R CMV positive | 1.28 | 0.43–3.78 | 0.65 |
ATG vs PT-Cy | 0.97 | 0.52–1.81 | 0.93 |
PB vs BM | 3.00 | 1.35–6.70 | <0.01 |
Center (frailty) | 0.93 | ||
cGVHD | |||
Age (per 10 years) | 0.97 | 0.69–1.37 | 0.89 |
Status at Tx
| |||
CR1 (reference) | 1 | ||
CR2+ | 0.58 | 0.20–1.71 | 0.33 |
Advanced | 0.62 | 0.20–1.90 | 0.40 |
Ph + vs Ph− | 0.86 | 0.33–2.20 | 0.75 |
KPS 90% | 0.68 | 0.26–1.77 | 0.43 |
Female recipient | 0.93 | 0.34–2.57 | 0.90 |
Female D ≥ male R | 1.38 | 0.48–3.94 | 0.54 |
RIC vs MAC | 0.94 | 0.38–2.36 | 0.91 |
R CMV positive | 0.51 | 0.16–1.56 | 0.24 |
ATG vs PT-Cy | 0.67 | 0.25–1.73 | 0.41 |
PB vs BM | 1.98 | 0.76–5.14 | 0.15 |
Center (frailty) | 0.13 |