Haploidentical donor is preferred over matched sibling donor for pre-transplantation MRD positive ALL: a phase 3 genetically randomized study

Chang, Ying-Jun; Wang, Yu; Xu, Lan-Ping; Zhang, Xiao-Hui; Chen, Huan; Chen, Yu-Hong; Wang, Feng-Rong; Wei-Han; Sun, Yu-Qian; Yan, Chen-Hua; Tang, Fei-Fei; Mo, Xiao-Dong; Liu, Yan-Rong; Liu, Kai-Yan; Huang, Xiao-Jun

doi:10.1186/s13045-020-00860-y

Table 3 Uni- and multivariate analysis of factors associated with transplantation outcomes (n = 208)

From: Haploidentical donor is preferred over matched sibling donor for pre-transplantation MRD positive ALL: a phase 3 genetically randomized study

Covariate	Univariate analysis			Multivariate analysis
Covariate	HR	95% CI	P value	HR	95% CI	P value
Neutrophil engraftment
CD34 cell infused (less vs. higher than median)	0.776	0.589–1.021	0.070	0.749	0.567–0.988	0.041
Transplant modality (Haplo-SCT vs. MSDT)	1.275	0.899–1.809	0.173
Platelet engraftment
CD34 cell infused (less vs. higher than median)	0.648	0.490–0.857	0.002	0.671	0.506–0.889	0.006
Transplant modality (Haplo-SCT vs. MSDT)	0.388	0.269–0.561	< 0.001	0.401	0.227–0.581	< 0.001
Acute GVHD grades II–IV
Disease status (≥ CR2 vs. CR1)	2.464	1.333–4.557	0.004	2.468	1.330–4.578	0.004
Transplant modality (Haplo-SCT vs. MSDT)	1.081	0.502–2.325	0.842
Total chronic GVHD
Time from diagnosis to transplant	1.011	1.000–1.022	0.053	1.011	1.000–1.022	0.050
Transplant modality (Haplo-SCT vs. MSDT)	0.949	0.548–1.641	0.850
MRD positive after transplantation
Disease status (≥ CR2 vs. CR1)	1.690	0.943–3.031	0.078
Levels of pre-transplantation MRD	1.243	1.014–1.523	0.036	1.281	1.043–1.572	0.014
Transplant modality (Haplo-SCT vs. MSDT)	0.526	0.301–0.921	0.024	0.492	0.280–0.866	0.018
Relapse
Disease status (≥ CR2 vs. CR1)	2.356	1.343–4.134	0.003	2.528	1.357–4.707	0.003
Diagnosis			0.037			0.002
T-ALL	2.757	1.235–6.157	0.013	4.356	1.814–10.460	0.001
PH negative B-ALL	1.379	0.710–2.678	0.343	1.368	0.690–2.713	0.370
PH positive B-ALL	1.0			1.0
Levels of pre-transplantation MRD	2.204	1.267–3.835	0.005	1.320	1.060–1.642	0.013
Chronic GVHD (yes vs. no)	0.475	0.263–0.859	0.014	0.337	0.181–0.628	0.001
Post-transplantation MRD	2.168	1.283–3.664	0.004	2.149	1.253–3.685	0.005
Transplant modality (Haplo-SCT vs. MSDT)	0.465	0.265–0.815	0.008	0.360	0.197–0.655	0.001
Non-relapse mortality
Platelet engraftment (Yes vs. no)	0.038	0.015–0.097	< 0.001	0.048	0.018–0.122	< 0.001
Grades II–IV acute GVHD	3.382	1.481–7.723	0.004	2.573	1.102–6.008	0.029
Transplant modality (Haplo-SCT vs. MSDT)	1.095	0.372–3.218	0.869	0.663	0.213–2.061	0.478
Leukemia-free survival
Disease status (≥ CR2 vs. CR1)	2.015	1.238–3.278	0.005	1.789	1.059–3.024	0.030
Diagnosis			0.013			0.021
T-ALL	2.653	1.351–5.208	0.005	2.696	1.308–5.558	0.007
PH negative B-ALL	1.357	0.776–2.371	0.284	1.375	0.765–2.472	0.287
PH positive B-ALL	1.0			1.0
Levels of pre-transplantation MRD	1.358	1.160–1.590	< 0.001	1.747	1.011–3.021	0.046
Platelet engraftment (yes vs. no)	0.130	0.062–0.275	< 0.001	0.153	0.067–0.352	< 0.001
Grades II–IV acute GVHD	1.991	1.232–3.218	0.005	1.727	1.036–2.879	0.036
Chronic GVHD (yes vs. no)	0.474	0.288–0.781	0.003	0.476	0.282–0.803	0.005
Post-transplantation MRD	1.500	0.955–2.357	0.078	1.707	1.059–2.752	0.028
Transplant modality (Haplo-SCT vs. MSDT)	0.570	0.349–0.933	0.025	0.425	0.252–0.718	0.001
Overall survival
Disease status (≥ CR2 vs. CR1)	2.311	1.404–3.806	0.001	2.238	1.321–3.790	0.003
Diagnosis			0.015			0.005
T-ALL	2.938	1.414–6.105	0.004	3.602	1.670–7.770	0.001
PH negative B-ALL	1.631	0.890–2.987	0.113	1.938	1.044–3.596	0.036
PH positive B-ALL	1.0			1.0
Levels of pre-transplantation MRD	1.312	1.107–1.555	0.002	1.202	0.975–1.482	0.085
Platelet engraftment (yes vs. no)	0.077	0.036–0.169	< 0.001	0.083	0.034–0.199	< 0.001
Grades II–IV acute GVHD	2.555	1.559–4.185	< 0.001	2.426	1.442–4.082	0.001
Chronic GVHD (yes vs. no)	0.482	0.292–0.794	0.004	0.469	0.269–0.820	0.008
Post-transplantation MRD	1.438	0.915–2.259	0.116	1.649	0.990–2.746	0.055
Transplant modality (Haplo-SCT vs. MSDT)	0.584	0.348–0.980	0.042	0.395	0.225–0.695	0.001

All variables were first included in the univariate analysis; only variables with P<0.1 and the forced variable (transplant modality) were included in the Cox proportional hazards model with time-dependent variables
HR hazard ratio, CI confidence interval, MRD minimal residual disease, CR complete remission, Haplo-SCT haploidentical stem cell transplantation, MSDT human leukocyte antigen-matched sibling donor transplantation, ALL acute lymphoblastic leukemia, GVHD graft-versus-host disease

Back to article page

ISSN: 1756-8722

Contact us

General enquiries: journalsubmissions@springernature.com

Journal of Hematology & Oncology

Contact us