Table 1.
Characteristics of adults with Ph+ ALL who received reduced intensity conditioning (RIC) allogeneic donor HCT in CR1 between 2000–2009 and a matched cohort receiving myeloablative (MAC) allogeneic HCT
| Variable | RIC | MAC | P-value |
|---|---|---|---|
| Number of patients | 67 | 130 | |
| Number of centers | 30 | 66 | |
| Age, median (range) | 54 (19–69) | 50 (19–66) | 0.02 |
| Sex | 0.94 | ||
| Male | 37 (55) | 71 (55) | |
| Female | 30 (45) | 59 (45) | |
| Karnofsky score | 0.36 | ||
| < 80% | 8 (12) | 8 (6) | |
| 80 – 100% | 54 (81) | 113 (87) | |
| Missing | 5 (7) | 9 (7) | |
| HCT Comorbidity Index | 0.03 | ||
| 0 | 54 (81) | 119 (92) | |
| ≥1 | 13 (19) | 11 (8) | |
| Fungal infection prior to HCT | 0.006 | ||
| No | 57 (85) | 126 (97) | |
| Yes | 8 (12) | 4 (3) | |
| Missing | 2 (3) | 0 | |
| WBC at diagnosis, ×10^9/L | 0.23 | ||
| < 30 | 41 (61) | 70 (54) | |
| 30 – 100 | 14 (21) | 23 (18) | |
| > 100 | 5 (7) | 24 (18) | |
| Missing | 7 (10) | 13 (10) | |
| Cytogenetic abnormalities | 0.34 | ||
| t(9:22) only | 32 (48) | 48 (37) | |
| t(9:22) and other | 25 (37) | 58 (45) | |
| Other | 4 (6) | 5 (4) | |
| Missing | 6 (9) | 19 (15) | |
| Time from diagnosis to 1st complete remission | 0.76 | ||
| Median (interquartile range) in days | 42 (34–82) | 52 (31–111) | |
| Missing | 1 (1) | 7 (5) | |
| Time from diagnosis to transplant | 0.02 | ||
| ≤ 5 months | 20 (30) | 64 (49) | |
| > 5 months | 46 (69) | 66 (51) | |
| Missing | 1 (1) | 0 | |
| Minimal residual disease pre-HCT | |||
| FISH tested | 59 (88) | 113 (87) | 0.75 |
| FISH neg/tested for MRD | 36/59 (54) | 63/113 (48) | |
| FISH pos/tested for MRD | 23/59 (34) | 50/113 (38) | |
| FISH not performed or unknown | 8 (12) | 17 (13) | |
| BCR/ABL PCR tested | 42 (63) | 82 (63) | 0.73 |
| PCR neg/tested for MRD | 21/42 (50) | 46/82 (35) | |
| PCR pos/tested for MRD | 21/42 (50) | 36/82 (28) | |
| PCR not performed or unknown | 24 (36) | 48 (37) | |
| MRDneg** | 26 (39) | 58 (49) | 0.79 |
| MRDpos* | 39 (58) | 62 (47) | |
| TKI use prior to HCT | 0.71 | ||
| No | 16 (24) | 28 (22) | |
| Yes | 51 (76) | 102 (78) | |
| Duration of TKI pre HCT, months | 0.41 | ||
| Median (range) | 7 (1–12) | 6 (1–54) | |
| <6 month | 28 (42) | 66 (51) | |
| ≥6 month | 15 (22) | 18 (14) | |
| TKI not given or unknown | 24 (36) | 48 (36) | |
| Conditioning regimen | N/A | ||
| MAC | |||
| TBI>500 cGy single dose or > 800cGy | 0 | 108 (83) | |
| Busulfan > 9 mg/kg + other | 0 | 22 (17) | |
| RIC (includes non-myeloablative) | |||
| Melphalan ≤ 150 mg/m2 | 24 (36) | 0 | |
| Busulfan ≤ 9 mg/kg | 20 (30) | 0 | |
| TBI ≤ 200 cGy dose# | 18 (26) | 0 | |
| Fludarabine + other | 5 (7) | 0 | |
| Total body irradiation | N/A | ||
| No | 45 (67) | 22 (17) | |
| Yes | 21 (31) | 108 (83) | |
| Missing | 1 (1) | 0 | |
| Type of donor | 0.10 | ||
| HLA - identical sibling | 26 (39) | 50 (38) | |
| Well - matched URD | 28 (42) | 54 (42) | |
| Partially – matched/ mismatched URD | 5 (7) | 21 (16) | |
| URD (matching unknown) | 8 (12) | 5 (4) | |
| Donor –Recipient sex match | 0.79 | ||
| Male-Male | 22 (33) | 47 (36) | |
| Male-Female | 18 (27) | 40 (31) | |
| Female-Male | 15 (22) | 24 (18) | |
| Female-Female | 12 (18) | 18 (14) | |
| Missing | 0 | 1 (<1) | |
| Donor-Recipient CMV match | 0.55 | ||
| Donor positive/Recipient positive | 27 (40) | 39 (30) | |
| Donor positive/Recipient negative | 9 (13) | 15 (12) | |
| Donor negative/Recipient positive | 14 (21) | 35 (27) | |
| Donor negative/Recipient negative | 15 (22) | 38 (29) | |
| Missing | 2 (3) | 3 (2) | |
| Graft type | 0.12 | ||
| Bone marrow | 15 (22) | 43 (33) | |
| Peripheral blood | 52 (78) | 87 (67) | |
| Year of transplant | 0.53 | ||
| 2001–2004 | 40 (59) | 70 (54) | |
| 2005–2009 | 27 (41) | 60 (46) | |
| GVHD prophylaxis | 0.36 | ||
| Tacrolimus ± other | 61 (46) | 72 (58) | |
| Cyclosporine ± other | 30 (45) | 47 (36) | |
| ATG/alemtuzumab | 25 (37) | 23 (17) | 0.032 |
| Other | 6 (8) | 9 (7) | |
| Median follow-up of survivors: months (range) | 49 (3–108) | 61 (3–119) | |
| Post-transplant therapy | |||
| Any TKI given as maintenance post-HCT | 0.02 | ||
| No | 46 (69) | 108 (83) | |
| Yes | 21 (31) | 22 (17) | |
| Duration of TKI given for maintenance post-HCT | 0.05 | ||
| < 3 months | 7 (10) | 4 (3) | |
| 3–12 months | 9 (13) | 9 (7) | |
| ≤ 12 months | 4 (6) | 9 (7) |
*
Includes both FISH and/or BCR/ABL PCR positive,
**
Includes FISH negative and BCR/ABL PCR negative or missing,
#
one patient received TBI <500 cGy single dose
Abbreviations: ALL acute lymphoblastic leukemia, RIC reduced intensity conditioning, MAC myeloablative conditioning, HCT hematopoietic cell transplantation, MRD minimal residual disease, TKI tyrosine kinase inhibitor, CMV cytomegalovirus, TBI total body irradiation, GVHD graft versus host disease,