Table 1.
Characteristics of patients who received HLA-identical sibling donor or unrelated donor allogeneic hematopoietic-cell transplant for acute myeloid leukemia in the United States from 1980-2005.
| Children | Adolescent and young adults | Older adults | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Characteristics | 1980-1988 | 1989-1997 | 1998-2005 | P- value |
1980- 1988 |
1989- 1997 |
1998- 2005 |
P- value |
1980- 1988 |
1989- 1997 |
1998- 2005 |
P- value |
| N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | N (%) | ||||
| Number of Patients | 110 | 373 | 417 | 462 | 1109 | 1137 | 57 | 683 | 1988 | |||
| Number of Centers | 19 | 60 | 67 | 36 | 105 | 111 | 17 | 87 | 102 | |||
| Male | 51 (46) | 209 (56) | 229 (55) | 230 (50) | 605 (55) | 610 (54) | 36 (63) | 360 (53) | 1068 (54) | |||
| Race/ethnicity | 0.01 | <0.01 | 0.09 | |||||||||
| White | 90 (82) | 299 (80) | 293 (70) | 414 (90) | 940 (85) | 936 (82) | 48 (84) | 617 (90) | 1809 (91) | |||
| Other | 19 (16) | 73 (20) | 123 (29) | 47 (10) | 168 (16) | 190 (19) | 9 ( 6) | 65 (10) | 163 ( 8) | |||
| Missing | 1 ( 1) | 1 (<1) | 1 (<1) | 1 (<1) | 1 (<1) | 11 ( 1) | 0 | 1 (<1) | 16 ( 1) | |||
| Performance status score at HCT | 0.90 | <0.01 | <0.01 | |||||||||
| < 90 | 20 (18) | 76 (20) | 75 (18) | 128 (28) | 389 (35) | 348 (31) | 19 (33) | 309 (45) | 681 (34) | |||
| ≥ 90 | 87 (79) | 294 (79) | 307 (74) | 323 (70) | 708 (64) | 691 (61) | 36 (63) | 370 (54) | 1093 (55) | |||
| Missing | 3 ( 3) | 3 ( 1) | 35 ( 8) | 11 ( 2) | 12 ( 1) | 98 ( 9) | 2 ( 4) | 4 ( 1) | 214 (11) | |||
| Disease status at HCT | <0.01 | <0.01 | <0.01 | |||||||||
| CR1 | 69 (63) | 169 (45) | 163 (39) | 263 (57) | 401 (36) | 397 (35) | 24 (42) | 203 (30) | 764 (38) | |||
| CR2 | 19 (17) | 67 (18) | 134 (32) | 52 (11) | 198 (18) | 275 (24) | 6 (11) | 94 (14) | 380 (19) | |||
| Primary induction failure | 5 ( 5) | 53 (14) | 42 (10) | 48 (10) | 151 (14) | 156 (14) | 9 (16) | 133 (19) | 331 (17) | |||
| Relapse | 16 (15) | 76 (20) | 69 (17) | 84 (18) | 318 (29) | 283 (25) | 17 (30) | 231 (34) | 443 (22) | |||
| Other/Missing | 1 (<1) | 8 ( 2) | 9 ( 2) | 15 ( 3) | 41 ( 4) | 26 ( 2) | 1 ( 2) | 22 ( 3) | 70 ( 6) | |||
| Cytogenetic risk at diagnosis | <0.01 | <0.01 | <0.01 | |||||||||
| Good | 7 ( 6) | 30 ( 8) | 34 ( 8) | 21 ( 5) | 83 ( 7) | 78 ( 7) | 4 ( 7) | 28 ( 4) | 87 ( 4) | |||
| Intermediate | 23 (21) | 185 (50) | 240 (58) | 111 (24) | 457 (41) | 703 (62) | 18 (32) | 353 (52) | 1217 (61) | |||
| Poor | 3 ( 3) | 60 (16) | 79 (19) | 26 ( 6) | 140 (13) | 193 (17) | 5 ( 9) | 96 (14) | 408 (21) | |||
| Unknown | 77 (70) | 98 (26) | 64 (15) | 304 (66) | 429 (39) | 163 (14) | 30 (53) | 206 (30) | 276 (14) | |||
| Time from diagnosis to HCT | <0.01 | <0.01 | 0.12 | |||||||||
| < 6 months | 73 (66) | 201 (54) | 200 (48) | 311 (67) | 480 (43) | 455 (40) | 33 (58) | 290 (42) | 831 (42) | |||
| 6-12 months | 18 (16) | 104 (28) | 83 (20) | 82 (18) | 340 (31) | 339 (30) | 10 (18) | 213 (31) | 603 (30) | |||
| > 12 months | 19 (17) | 66 (18) | 134 (32) | 69 (15) | 288 (26) | 339 (30) | 14 (25) | 178 (26) | 549 (28) | |||
| Missing | 0 | 2 ( 1) | 0 | 0 | 1 (<1) | 4 (<1) | 0 | 2 (<1) | 5 (<1) | |||
| Graft type | <0.01 | <0.01 | <0.01 | |||||||||
| Bone marrow | 110 (100) | 370 (99) | 340 (82) | 462 (100) | 1056 (95) | 609 (54) | 57 (100) | 627 (92) | 694 (35) | |||
| Peripheral blood | 0 | 3 ( 1) | 77 (18) | 0 | 53 ( 5) | 528 (46) | 0 | 56 ( 8) | 1294 (65) | |||
| HLA match* | <0.01 | <0.01 | <0.01 | |||||||||
| HLA-identical sibling | 110 | 171 (46) | 86 (21) | 462 | 604 (54) | 221 (19) | 57 | 421 (62) | 553 (28) | |||
| Unrelated, well-matched | 0 | 37 (10) | 134 (32) | 0 | 91 ( 8) | 446 (39) | 0 | 74 (11) | 897 (45) | |||
| Unrelated, partially matched | 0 | 72 (19) | 116 (28) | 0 | 206 (19) | 318 (28) | 0 | 111 (16) | 382 (19) | |||
| Unrelated, mismatched | 0 | 87 (23) | 75 (18) | 0 | 207 (19) | 140 (12) | 0 | 73 (11) | 135 ( 7) | |||
| Missing | 0 | 6 ( 2) | 6 ( 1) | 0 | 1 (<1) | 12 ( 1) | 0 | 4 ( 1) | 21 ( 1) | |||
| Conditioning regimen | 0.16 | <0.01 | <0.01 | |||||||||
| Myeloablative | 109 (99) | 354 (95) | 387 (93) | 453 (98) | 1051 (95) | 944 (83) | 56 (98) | 657 (96) | 1145 (58) | |||
| RIC/NMA | 1 ( 1) | 19 ( 5) | 19 ( 5) | 9 ( 2) | 58 ( 5) | 161 (14) | 1 ( 2) | 25 ( 4) | 776 (39) | |||
| Missing | 0 | 0 | 11 ( 3) | 0 | 0 | 32 ( 3) | 0 | 1 (<1) | 67 ( 3) | |||
| GVHD prophylaxis | <0.01 | <0.01 | <0.01 | |||||||||
| CSA + MTX ± other | 14 (13) | 193 (52) | 207 (50) | 58 (13) | 576 (52) | 445 (39) | 8 (14) | 350 (51) | 550 (28) | |||
| CSA ± other (no MTX) | 20 (18) | 44 (12) | 18 ( 4) | 162 (35) | 229 (21) | 74 ( 7) | 25 (44) | 139 (20) | 360 (18) | |||
| FK506 + MTX | 0 | 6 ( 2) | 66 (16) | 0 | 60 ( 5) | 370 (33) | 0 | 39 ( 6) | 669 (34) | |||
| MTX | 74 (67) | 36 (10) | 12 ( 3) | 178 (39) | 33 ( 3) | 9 ( 1) | 8 (14) | 12 ( 2) | 11 ( 1) | |||
| T-cell depletion | 2 ( 2) | 92 (25) | 98 (24) | 59 (13) | 183 (17) | 142 (12) | 16 (28) | 106 (16) | 125 ( 6) | |||
| Other | 0 | 2 ( 1) | 16 ( 4) | 5 ( 1) | 28 ( 3) | 97 ( 9) | 0 | 37 ( 5) | 273 (14) | |||
| Recipient/Donor gender match | 0.23 | <0.01 | <0.01 | |||||||||
| Recipient male/Donor male | 24 (22) | 126 (34) | 144 (35) | 136 (29) | 350 (32) | 391 (34) | 22 (39) | 206 (30) | 675 (34) | |||
| Recipient male/Donor female | 28 (25) | 90 (24) | 99 (24) | 113 (24) | 243 (22) | 297 (26) | 9 (16) | 156 (23) | 544 (27) | |||
| Recipient female/Donor male | 27 (25) | 82 (22) | 84 (20) | 94 (20) | 253 (23) | 218 (19) | 14 (25) | 151 (22) | 392 (20) | |||
| Recipient female/Donor female | 31 (28) | 74 (20) | 88 (21) | 119 (26) | 256 (23) | 229 (20) | 12 (21) | 165 (24) | 373 (19) | |||
| Missing | 0 | 1 (<1) | 2 (<1) | 0 | 7 ( 1) | 2 (<1) | 0 | 5 ( 1) | 4 (<1) | |||
| Recipient/Donor CMV status | <0.01 | <0.01 | <0.01 | |||||||||
| Recipient and donor negative | 16 (15) | 164 (44) | 154 (37) | 75 (16) | 304 (27) | 357 (31) | 7 (12) | 142 (21) | 482 (24) | |||
| Recipient or donor positive | 22 (20) | 202 (54) | 249 (60) | 153 (33) | 779 (70) | 768 (68) | 36 (63) | 534 (78) | 1478 (74) | |||
| Missing | 72 (65) | 7 ( 2) | 14 ( 3) | 234 (51) | 26 ( 2) | 12 ( 1) | 14 (25) | 7 ( 1) | 28 ( 1) | |||
| Occurrence of acute GVHD | 0.02 | 0.04 | 0.78 | |||||||||
| Yes | 42 (38) | 167 (45) | 222 (53) | 225 (49) | 537 (48) | 627 (55) | 27 (47) | 342 (50) | 1002 (50) | |||
| No | 67 (61) | 204 (55) | 194 (47) | 235 (51) | 560 (50) | 502 (44) | 30 (53) | 340 (50) | 981 (49) | |||
| Missing | 1 ( 1) | 2 ( 1) | 1 (<1) | 2 (<1) | 12 ( 1) | 8 ( 1) | 0 | 1 (<1) | 5 (<1) | |||
| Occurrence of chronic GVHD | 0.95 | <0.01 | <0.01 | |||||||||
| Yes | 31 (28) | 98 (26) | 122 (29) | 154 (33) | 348 (31) | 464 (41) | 15 (26) | 192 (28) | 799 (40) | |||
| No | 79 (72) | 259 (69) | 294 (71) | 308 (67) | 691 (62) | 669 (59) | 42 (74) | 467 (68) | 1189 (60) | |||
| Missing | 0 | 16 ( 4) | 1 (<1) | 0 | 70 ( 6) | 4 (<1) | 0 | 24 ( 4) | 0 | |||
| Follow-up, months | ||||||||||||
| Median | 163 | 116 | 59 | 147 | 120 | 50 | 158 | 130 | 47 | |||
| Range | 37 - 315 | 4-214 | 3-132 | 6-328 | 3-239 | 3-133 | 49-302 | 4-235 | 2-121 | |||
KPS – Karnofsky performance status, HCT – hematopoietic cell transplantation, US – United States, CR – complete remission, RIC – reduced intensity conditioning, NMA – non-myeloablative conditioning, GVHD – graft-versus-host disease, CSA – cyclosporine, MTX – methotrexate, FK506 – tacrolimus, CMV – cytomegalovirus
*
Prior to 1989, 40 URD HCT recipients (all age groups) met the study eligibility criteria; these patients were not considered in this analysis.