Table 3.
Risk factor analysis for overall mortality after DLI
| Univariate | Multivariate (n=181) | |||
|---|---|---|---|---|
| HR (95% CI) | p-value | HR (95% CI) | p-value | |
| CD3+ cell dose | ||||
| ≤ 107 cells/kg | 1.0 | 1.0 | ||
| >107 – <108 cells/kg | 1.35 (0.9–2.0) | 0.16 | 0.98 (0.6–1.7) | 0.93 |
| ≥108 cells/kg | 1.64 (1.1–2.4) | 0.01 | 1.25 (0.7–2.3) | 0.48 |
| Patient age at DLI | ||||
| 0–29 years | 1.0 | 1.0 | ||
| 30–44 years | 0.99 (0.6–1.6) | 0.95 | 1.02 (0.6–1.9) | 0.95 |
| 45–59 years | 1.02 (0.6–1.6) | 0.94 | 1.44 (0.8–2.7) | 0.25 |
| 60–74 years | 1.42 (0.8–2.4) | 0.20 | 2.69 (1.1–6.3) | 0.02 |
| Donor-recipient gender | ||||
| Other | 1.0 | |||
| Female to male | 1.19 (0.8–1.7) | 0.38 | ||
| Disease diagnosis/risk at time of DLI | ||||
| CML chronic phase | 1.0 | 1.0 | ||
| Low risk lymphoid malignancies | 2.93 (1.5–5.8) | 0.002 | 1.47 (0.5–4.2) | 0.48 |
| High risk myeloid malignancies | 5.05 (2.8–9.1) | <0.0001 | 2.29 (1.0–5.4) | 0.06 |
| High risk lymphoid malignancies | 4.64 (2.4–9.0) | <0.0001 | 2.62 (1.0–6.8) | 0.05 |
| Disease status at time of DLI | ||||
| Complete remission (CR) | 1.0 | |||
| Not in CR | 1.18 (0.8–1.7) | 0.39 | ||
| Donor origin | ||||
| Related | 1.0 | 1.0 | ||
| Unrelated | 0.86 (0.6–1.3) | 0.44 | 1.05 (0.6–1.8) | 0.87 |
| Donor-recipient HLA match | ||||
| Matched | 1.0 | |||
| Mismatched | 1.14 (0.6–2.2) | 0.70 | ||
| Graft stem cell source | ||||
| Bone Marrow | 1.0 | 1.0 | ||
| Mobilized blood | 1.72 (1.2–2.4) | 0.002 | 1.42 (0.8–2.5) | 0.22 |
| Conditioning intensity | ||||
| Myeloablative | 1.0 | 1.0 | ||
| Nonmyeloablative | 1.24 (0.9–1.8) | 0.24 | 0.75 (0.4–1.6) | 0.46 |
| Prior acute GVHD (n=218) | ||||
| 0–I | 1.0 | |||
| II–IV | 1.07 (0.8–1.5) | 0.68 | ||
| Prior chronic GVHD | ||||
| No | 1.0 | |||
| Yes | 0.98 (0.7–1.4) | 0.89 | ||
| Time from HCT to DLI | ||||
| > 1 year | 1.0 | 1.0 | ||
| ≤ 1 year | 3.04 (2.2–4.2) | <0.0001 | 2.66 (1.7–4.2) | <0.0001 |
| Cytoreduction before DLI | ||||
| No | 1.0 | 1.0 | ||
| Yes | 2.35 (1.6–3.4) | <0.0001 | 1.37 (0.7–2.5) | 0.31 |
| Donor CD3 chimerism at time of DLI | ||||
| > 95% | 1.0 | |||
| ≤ 95% | 1.39 (0.8–2.4) | 0.25 | ||
| Donor BM chimerism at time of DLI | ||||
| > 95% | 1.0 | |||
| ≤ 95% | 2.08 (1.3–3.3) | 0.003 | ||
| Lymphocyte count at time of DLI | ||||
| ≥ 103/microL | 1.0 | 1.0 | ||
| < 103/microL | 1.72 (1.2–2.4) | 0.001 | 1.16 (0.8–1.8) | 0.50 |
| G-CSF mobilized product for DLI | ||||
| No | 1.0 | |||
| Yes | 1.06 (0.7–1.7) | 0.81 | ||
| IL-2 after DLI | ||||
| No | 1.0 | |||
| Yes | 1.41 (0.8–2.5) | 0.23 | ||
| Year of DLI | ||||
| 1992–1996 | 1.0 | 1.0 | ||
| 1997–2001 | 0.89 (0.6–1.4) | 0.59 | 0.65 (0.4–1.1) | 0.10 |
| 2001–2006 | 0.79 (0.5–1.2) | 0.30 | 0.46 (0.2–0.9) | 0.02 |
| 2007–2011 | 0.58 (0.3–1.1) | 0.09 | 0.27 (0.1–0.6) | 0.002 |