Non-T-depleted haploidentical transplantation with post-transplant cyclophosphamide in patients with secondary versus de novo AML in first complete remission: a study from the ALWP/EBMT

Table 4 (A) Multivariate analysis, (B) multivariate analysis-sAML per antecedent hematological disorder versus de novo AML

(A)
	RELAPSE		NRM		LFS
	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
sAML versus do novo	1.02 (0.72–1.45)	0.91	0.97 (0.7–1.35)	0.87	1 (0.79–1.27)	0.99
Patient age (per 10 years)	0.98 (0.89–1.08)	0.62	1.36 (1.21–1.52)	< 0.0001	1.14 (1.06–1.23)	5.00E−04
Adverse versus intermediate cytogenetics	1.95 (1.53–2.49)	< 0.0001	1.22 (0.95–1.56)	0.12	1.54 (1.29–1.83)	< 0.0001
Time diagnosis to HSCT (mo)	1 (0.96–1.04)	0.86	1.03 (0.99–1.06)	0.13	1.01 (0.99–1.04)	0.36
KPS > 90	0.79 (0.59–1.04)	0.09	0.7 (0.54–0.92)	0.009	0.73 (0.6–0.88)	0.001
RIC versus MAC	1.4 (1.06–1.85)	0.016	1.1 (0.84–1.45)	0.48	1.24 (1.02–1.5)	0.031
Female to male versus other	1.22 (0.91–1.63)	0.18	1.25 (0.95–1.65)	0.1	1.24 (1.02–1.52)	0.031
Pat. CMV pos	1.04 (0.77–1.42)	0.78	1.33 (0.95–1.85)	0.094	1.17 (0.93–1.46)	0.18
Don. CMV pos	0.85 (0.65–1.1)	0.21	1.14 (0.88–1.48)	0.32	0.99 (0.82–1.19)	0.93
PBSC versus BM	0.91 (0.7–1.19)	0.49	0.93 (0.7–1.22)	0.58	0.92 (0.76–1.11)	0.39
Centre (frailty term)		0.24		0.014		0.11

	OS		GRFS		Acute GVHD II-IV
	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
sAML versus do novo	0.95 (0.74–1.23)	0.72	0.94 (0.75–1.17)	0.57	1.04 (0.77–1.41)	0.8
Patient age (per 10 years)	1.22 (1.13–1.33)	< 0.0001	1.09 (1.02–1.17)	0.008	1.07 (0.97–1.17)	0.16
Adverse versus intermediate cytogenetics	1.56 (1.29–1.87)	< 0.0001	1.44 (1.24–1.69)	< 0.0001	0.99 (0.8–1.24)	0.94
Time diagnosis to HSCT (mo)	1.01 (0.99–1.04)	0.34	1 (0.98–1.03)	0.71	0.97 (0.94–1.01)	0.098
KPS > 90	0.74 (0.6–0.91)	0.005	0.81 (0.68–0.97)	0.019	0.82 (0.64–1.06)	0.13
RIC versus MAC	1.29 (1.05–1.59)	0.018	1.18 (0.99–1.41)	0.072	0.95 (0.74–1.22)	0.68
Female to male versus other	1.3 (1.05–1.6)	0.015	1.28 (1.07–1.53)	0.006	0.81 (0.62–1.05)	0.12
Pat. CMV pos	1.16 (0.91–1.48)	0.23	1.1 (0.9–1.34)	0.35	1.01 (0.77–1.31)	0.97
Don. CMV pos	1.05 (0.86–1.28)	0.65	0.99 (0.84–1.18)	0.95	1.02 (0.81–1.27)	0.89
PBCS versus BM	0.89 (0.72–1.09)	0.26	1.12 (0.93–1.34)	0.23	1.79 (1.35–2.39)	< 0.0001
Centre (frailty term)		0.017		0.015		< 0.0001

	Acute GVHD III–IV		Chronic GVHD		Extensive chronic GVHD
	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
sAML versus do novo	0.73 (0.41–1.32)	0.3	0.96 (0.71–1.29)	0.78	0.65 (0.39–1.08)	0.097
Patient age (per 10 years)	1.01 (0.87–1.17)	0.92	1.07 (0.99–1.17)	0.1	1.09 (0.95–1.25)	0.24
Adverse versus intermediate cytogenetics	1.03 (0.7–1.51)	0.89	1.06 (0.85–1.32)	0.63	1.32 (0.93–1.86)	0.11
Time diagnosis to HSCT (mo)	0.98 (0.92–1.04)	0.5	1.01 (0.97–1.04)	0.76	1 (0.94–1.05)	0.88
KPS > 90	0.8 (0.52–1.21)	0.29	1.06 (0.82–1.37)	0.68	1.05 (0.7–1.58)	0.82
RIC versus MAC	0.93 (0.61–1.39)	0.71	1.14 (0.9–1.45)	0.27	1.11 (0.76–1.64)	0.58
Female to male versus other	0.89 (0.56–1.41)	0.63	1.17 (0.92–1.49)	0.2	1.52 (1.05–2.19)	0.027
Pat. CMV pos	0.9 (0.58–1.41)	0.66	0.97 (0.74–1.26)	0.81	0.99 (0.64–1.54)	0.97
Don. CMV pos	1.01 (0.68–1.49)	0.98	1.02 (0.81–1.27)	0.89	1.21 (0.83–1.76)	0.31
PBCS versus BM	1.73 (1.09–2.74)	0.019	1.55 (1.19–2.02)	0.001	1.52 (0.99–2.34)	0.056
Centre (frailty term)		0.24		0.0005		0.0001

(B)
	RELAPSE		NRM		LFS
	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
de novo AML (reference)	1		1		1
MDS/MPN/BMFS	1.02 (0.67–1.56)	0.91	0.87 (0.57–1.31)	0.5	0.95 (0.71–1.27)	0.73
OMHD/ST	1.01 (0.58–1.76)	0.96	1.18 (0.72–1.93)	0.52	1.1 (0.76–1.59)	0.62
Patient age (per 10 years)	0.98 (0.89–1.08)	0.62	1.36 (1.21–1.52)	< 0.0001	1.14 (1.06–1.23)	0.0005
Adverse versus intermediate cytogenetics	1.95 (1.53–2.49)	< 0.0001	1.21 (0.94–1.56)	0.13	1.53 (1.29–1.82)	< 0.0001
Time diagnosis to HSCT (mo)	1 (0.96–1.04)	0.86	1.03 (0.99–1.06)	0.14	1.01 (0.99–1.04)	0.38
KPS > 90	0.79 (0.59–1.04)	0.09	0.7 (0.54–0.92)	0.009	0.73 (0.6–0.89)	0.001
RIC versus MAC	1.4 (1.06–1.85)	0.016	1.1 (0.84–1.45)	0.48	1.24 (1.02–1.5)	0.031
Female to male versus other	1.22 (0.91–1.63)	0.18	1.27 (0.96–1.67)	0.091	1.25 (1.02–1.52)	0.029
Pat. CMV pos	1.04 (0.77–1.42)	0.78	1.32 (0.95–1.85)	0.098	1.17 (0.93–1.46)	0.18
Don. CMV pos	0.85 (0.65–1.1)	0.21	1.14 (0.88–1.48)	0.32	0.99 (0.82–1.19)	0.93
PBSC versus BM	0.91 (0.7–1.19)	0.49	0.92 (0.7–1.22)	0.57	0.92 (0.76–1.11)	0.38
Centre (frailty term)		0.24		0.012		0.1

	OS		GRFS		Acute GVHD II–IV
	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
de novo AML (reference)	1		1		1
MDS/MPN/BMFS	0.88 (0.64–1.21)	0.43	0.97 (0.75–1.25)	0.8	1.09 (0.76–1.55)	0.65
OMHD/ST	1.1 (0.74–1.63)	0.63	0.89 (0.62–1.27)	0.52	0.95 (0.57–1.58)	0.84
Patient age (per 10 years)	1.22 (1.13–1.33)	< 0.0001	1.09 (1.02–1.17)	0.009	1.07 (0.97–1.17)	0.16
Adverse versus intermediate cytogenetics	1.55 (1.29–1.87)	< 0.0001	1.45 (1.24–1.69)	< 0.0001	0.99 (0.8–1.24)	0.96
Time diagnosis to HSCT (mo)	1.01 (0.98–1.04)	0.36	1 (0.98–1.03)	0.69	0.97 (0.94–1.01)	0.1
KPS > 90	0.74 (0.6–0.91)	0.005	0.81 (0.67–0.96)	0.019	0.82 (0.64–1.05)	0.12
RIC versus MAC	1.29 (1.04–1.59)	0.018	1.18 (0.99–1.41)	0.071	0.95 (0.74–1.22)	0.68
Female to male versus other	1.3 (1.06–1.61)	0.014	1.28 (1.07–1.53)	0.007	0.81 (0.62–1.05)	0.11
Pat. CMV pos	1.16 (0.91–1.47)	0.24	1.1 (0.9–1.34)	0.35	1.01 (0.77–1.31)	0.97
Don. CMV pos	1.05 (0.86–1.28)	0.66	0.99 (0.84–1.18)	0.95	1.02 (0.81–1.27)	0.9
PBCS versus BM	0.89 (0.72–1.09)	0.25	1.12 (0.93–1.34)	0.23	1.79 (1.35–2.39)	< 0.0001
Centre (frailty term)		0.015		0.016		< 0.0001

	Acute GVHD III-IV		Chronic GVHD		Extensive chronic GVHD
	HR (95% CI)	p value	HR (95% CI)	p value	HR (95% CI)	p value
de novo AML (reference)	1		1		1
MDS/MPN/BMFS	0.77 (0.39–1.55)	0.47	1.14 (0.82–1.6)	0.42	0.81 (0.46–1.42)	0.46
OMHD/ST	0.66 (0.24–1.81)	0.42	0.62 (0.35–1.09)	0.099	0.32 (0.1–1.02)	0.055
Patient age (per 10 years)	1.01 (0.87–1.17)	0.92	1.07 (0.99–1.17)	0.099	1.08 (0.94–1.24)	0.25
Adverse versus intermediate cytogenetics	1.03 (0.7–1.51)	0.88	1.07 (0.86–1.33)	0.56	1.34 (0.95–1.89)	0.098
Time diagnosis to HSCT (mo)	0.98 (0.92–1.04)	0.51	1.01 (0.98–1.04)	0.66	1 (0.95–1.05)	0.97
KPS > 90	0.8 (0.52–1.21)	0.29	1.05 (0.81–1.36)	0.7	1.03 (0.69–1.55)	0.88
RIC versus MAC	0.93 (0.61–1.4)	0.71	1.14 (0.9–1.45)	0.27	1.12 (0.76–1.65)	0.55
Female to male versus other	0.89 (0.56–1.41)	0.62	1.17 (0.92–1.49)	0.21	1.52 (1.05–2.2)	0.027
Pat. CMV pos	0.91 (0.58–1.41)	0.66	0.97 (0.75–1.27)	0.83	0.99 (0.64–1.54)	0.98
Don. CMV pos	1.01 (0.68–1.49)	0.98	1.02 (0.81–1.27)	0.88	1.22 (0.84–1.77)	0.3
PBCS versus BM	1.73 (1.09–2.74)	0.019	1.55 (1.19–2.02)	0.001	1.52 (0.99–2.34)	0.055
Centre (fraitly term)		0.24		0.0006		0.0002

sAML secondary acute myeloid leukemia, MDS/MPN/BMF sAML post myelodysplastic syndrome, myeloproliferative neoplasm, bone marrow failure syndrome, OMHD/ST sAML post other malignant hematologic disorders and solid tumors, HSCT hematopoietic stem cell transplantation, mo month, NRM non-relapse mortality, RI relapse incidence, LFS leukemia-free survival, OS overall survival, GVHD graft-versus-host disease, GRFS GVHD-free, relapse-free survival, pos positive, KPS Karnofsky performance score, MAC myeloablative conditioning, RIC reduced intensity conditioning, CMV cytomegalovirus, Pat. patient, Don. Donor, BM bone marrow, PBSC peripheral blood stem cells

ISSN: 1756-8722