Table 3.
Multivariate Cox regression analysis of ABO mismatch effect on overall survival and non-relapse mortality. Significant associations are shown in bold text.
| Event | ABO Matched | ABO Minor MM | ABO Major MM | ABO Bidir MM |
|---|---|---|---|---|
| Overall survival, Stanford* | ||||
| Number evaluable | 1049 | 293 | 309 | 78 |
| HR (c.i.) | 1 | 1.56 (1.19 - 2.05) | 1.02 (0.85 - 1.23) | 0.87 (0.61 - 1.26) |
| P-value | – | 0.001 | 0.82 | 0.82 |
| Overall survival, CIBMTR (Ratanatharathorn)** | ||||
| Number evaluable | 240 | 73 | 73 | 22 |
| HR (c.i.) | 1 | 1.55 (1.07 - 2.25) | 0.86 (0.57 - 1.31) | 0.94 (0.37 -2.39) |
| P-value | – | 0.021 | 0.49 | 0.91 |
| Overall survival, CIBMTR (Luger)*** | ||||
| Number evaluable | 2540 | 1065 | 955 | 308 |
| HR (c.i.) | 1 | 1.06 (0.97 - 1.16) | 1.19 (1.08 - 1.31) | 1.13 (0.97 - 1.31) |
| P-value | – | 0.24 | <0.001 | 0.11 |
| NRM, Stanford* | ||||
| Number evaluable | 1049 | 293 | 309 | 78 |
| HR (c.i.) | 1 | 1.48 (1.06 - 2.06) | 0.91 (0.7 - 1.18) | 0.94 (0.57 - 1.55) |
| P-value | – | 0.02 | 0.47 | 0.81 |
| NRM, CIBMTR (Ratanatharathorn)** | ||||
| Number evaluable | 240 | 73 | 73 | 22 |
| HR (c.i.) | 1 | 1.72 (1.11 - 2.68) | 0.87 (0.52 - 1.46) | 1.42 (0.69 - 2.9) |
| P-value | – | 0.02 | 0.6 | 0.34 |
| NRM, CIBMTR (Luger)*** | ||||
| Number evaluable | 2540 | 1065 | 955 | 308 |
| HR (c.i.) | 1 | 1.07 (0.94 - 1.21) | 1.23 (1.08 - 1.4) | 1.11 (0.9 - 1.36) |
| P-value | – | 0.33 | 0.002 | 0.35 |
Variables included in the model are: ABO match (matched vs. minor mismatched vs. major mismatched vs. bidirectional mismatched), diagnosis category (leukemia vs. lymphoma vs. other), age at transplantation (<=20, 21-39,40-59, >=60), recipient gender (male vs. female), donor relatedness (HLA-identical sibling vs. unrelated), graft type (PBSC vs. bone marrow), indicator of joint ABO minor MM and PBSC, regimen type (myeloablative vs. non-myeloablative), transplant era (before 1998 vs. 1998 - 2004 vs. after 2004). The significant covariates for overall survival were: diagnosis (lymphoma vs. leukemia; HR 0.71, 95%CI 0.58-0.87, p=0.001) and (other vs. leukemia; HR 0.72, 95%CI 0.57 - 0.92, p=0.007), age at transplant (<=20 vs >=60; HR 0.51, 95%CI 0.36 - 0.71, p<0.0001) and (21-39 vs. >=60; HR 0.57, 95% CI 0.43 - 0.77, p=0.0002), graft type (PBSC vs. BM; HR 2.0, 95%CI 1.57 - 2.5, p<0.0001), joint ABO minor MM and PBSC indicator (1 vs 0, HR 0.65, 95%CI 0.46-0.92, p= 0.014), regimen type (non-myeloablative vs. ablative; HR 0.66, 95% CI 0.53 - 0.83, p=0.0002), and transplant era (before 1998 vs 1998 - 2004; HR 1.29, 95%CI 1.03 - 1.61, p=0.03) and (after 2004 vs 1998 - 2004; HR 0.84, 95%CI 0.71 - 0.99, p=0.04). The significant covariates for NRM were: age at transplant (<=20 vs >=60; HR 0.24, 95%CI 0.15 - 0.42, p<0.0001) and (21-39 vs. >=60; HR 0.43, 95% CI 0.27 - 0.68, p=0.0003), donor relatedness (unrelated vs. HLA-identical sibling; HR 1.36, p5% CI 1.05 - 1.76, p=0.02), graft type (PBSC vs. BM; HR 1.49, 95%CI 1.1 - 2.01, p=0.01), regimen type (non-myeloablative vs. ablative; HR 0.32, 95% CI 0.23 - 0.46, p<0.0001), and transplant era (before 1998 vs 1998 - 2004; HR 1.41, 95%CI 1.06 - 1.88, p=0.02) and (after 2004 vs 1998 - 2004; HR 0.71, 95%CI 0.55 - 0.90, p=0.006).
Variables included in CIBMTR analysis of Ratanatharathorn et al data: ABO match (matched vs. minor mismatched vs. major mismatched vs. bidirectional mismatched), age at transplantation (21-40 vs. 41-50 vs. 51-70), gender (male vs. female), performance status (<90 vs. >=90), lymphoma histology (small lymphocytic and follicular lymphoma vs. diffuse large B cell versus mantle cell), disease status prior to transplant (complete remission vs. partial remission vs. sensitive relapse vs. other relapse - ie, resistant/untreated/unknown/progressive disease), donor type (HLA-identical sibling vs. unrelated donor), interval from diagnosis to transplant, numbers of chemotherapy regimens received prior to transplantation (<=2 lines vs. 3-6 lines vs. >6 lines), previous radiation (yes vs. no), time from last dose of rituximab to transplantation (>6 months or no prior treatment vs. <=6 months), number of prior therapy with rituximab-containing regimens, conditioning regimens (myeloablative vs. non-myeloablative), GVHD prophylaxis (ciclosporin +/- others vs. tacrolimus +/- others), donor-recipient sex match (M>M vs. M>F vs. F>M vs. F>F), donor parity (male donor vs. nulliparous female donor vs. parous female donor vs. others), donor-recipient CMV serology (-/- vs. others), year of transplant (1999-2000 vs. 2001 - 2004), and HLA match (HLA-identifcal sibling vs. well-matched vs. partially matches/mismatched unrelated). Other significant covariates are listed in the original Ratanatharathorn et al. publication.
Variables included in CIBMTR analysis of Luger et al data: ABO match (matched vs. minor mismatched vs. major mismatched vs. bidirectional mismatched), age at transplant, gender, Karnofsky performance score (<90 vs. >=90% vs. unknown), disease (AML vs. MDS), FAB subtype at diagnosis (M0 - M2 vs. M4 - M7 vs. other/unclassified (for AML), rafractory anemia or acquired idiopathic siderblastic anemia vs. other MDS (for MDS)), therapy-related leukemia (no vs. yes vs. unknown), cytogenetics (good vs. intermediate vs. poor prognosis vs. unknown), blast percentage at transplant (<5 vs. 5-10 vs. >10% vs. unknown), duration of first CR for AML patients transplant in second CR (<6 vs. 6-12 months vs. unknown), disease status at transplant (primary induction failure vs. first CR vs >=second CR vs. relapse (for AML), treated vs. untreated (for MDS), time from remission to transplant for AML patients transplanted in first CR (<=3 vs >3 months vs unknown), type of donor (HLA-identical sibling vs. unrelated well-matched vs. unrelated partially matched vs. unrelated mismatched vs. unrelated matching unknown), donor age, donor-recipient sex match (F>M vs. other), donor-recipient CMV serology (-/- vs +/- vs. recipient + vs unknown), graft type (BM vs. PBSC), year of transplant, previous autologous transplant (no vs. yes), ATG (no vs. yes), and GVHD prophylaxis (tacrolimus + MTX +/- other vs. tacrolimus +/- other vs CSA + MTX +/- other vs CSA +/- other). Other significant covariates are listed in the original Luger et al. publication.