Table 3.
Multiple regression analysis of the effect of HLA-C matching score on the outcomes after dUCB transplantation in which there was an interaction with conventional HLA-matching at HLA-A,-B, and -DRB1.
| Match at HLA-A,B and DRB1 |
HLA 2–4/6 | HLA 5–6/6 | ||||
|---|---|---|---|---|---|---|
| N | HR (95% CI) | P-value | N | HR (95% CI) | P-value | |
| OVERALL SURVIVAL & | ||||||
| HLA-C match score | ||||||
| 4/4* | 29 | 1.0 (ref) | 48 | 1.0 (ref) | ||
| 3/4 | 77 | 2.4 (1.1–5.1) | 0.03 | 31 | 0.9 (0.5–1.6) | 0.63 |
| 2/4 | 171 | 2.9 (1.4–5.9) | <0.01 | 40 | 0.8 (0.4–1.4) | 0.41 |
| 1/4 | 59 | 2.8 (1.3–6.1) | 0.01 | 7** | 0.7 (0.2–2.5) | 0.57 |
| 0/4 | 53 | 3.3 (1.5–7.1) | <0.01 | |||
| Worst HLA-A,-B and -DRB1 Match | ||||||
| 6/6* | 24 | 1.0 (ref) | ||||
| 5/6 | 102 | 1.1 (0.6–2.1) | 0.85 | |||
| 4/6* | 256 | 1.0 (ref) | ||||
| 3/6 | 106 | 1.1 (0.8–1.4) | 0.81 | |||
| 2/6 | 27 | 0.8 (0.5–1.4) | 0.47 | |||
| Age | ||||||
| <18 | 26 | 1.0 (ref) | 21 | 1.0 (ref) | ||
| 18–34 | 77 | 1.6 (0.8–3.3) | 0.22 | 20 | 0.5 (0.2–1.3) | 0.15 |
| 35+ | 286 | 2.8 (1.4–5.8) | 0.01 | 85 | 0.3 (0.1–0.7) | 0.01 |
| Disease Risk | ||||||
| Standard risk* | 227 | 1.0 (ref) | 84 | 1.0 (ref) | ||
| High risk | 162 | 1.6 (1.2–2.1) | <0.01 | 42 | 1.1 (0.6–1.8) | 0.74 |
| Patient CMV | ||||||
| Negative* | 158 | 1.0 (ref) | NA | |||
| Positive | 231 | 1.6 (1.2–2.2) | <0.01 | NA | ||
| DISEASE-FREE SURVIVAL & | ||||||
| HLA-C match score | ||||||
| 4/4* | 29 | 1.0 (ref) | 48 | 1.0 (ref) | ||
| 3/4 | 77 | 1.8 (1.0–3.3) | 0.07 | 31 | 0.9 (0.5–1.6) | 0.67 |
| 2/4 | 171 | 1.9 (1.1–3.4) | 0.03 | 40 | 0.8 (0.4–1.5) | 0.47 |
| 1/4 | 59 | 2.1 (1.1–3.9) | 0.02 | 7** | 0.5 (0.1–1.8) | 0.30 |
| 0/4 | 53 | 2.2 (1.2–4.2) | 0.02 | |||
| Worst HLA-A,-B and -DRB1 Match | ||||||
| 6/6* | 24 | 1.0 (ref) | ||||
| 5/6 | 102 | 0.9 (0.7–1.7) | 0.79 | |||
| 4/6* | 256 | 1.0 (ref) | ||||
| 3/6 | 106 | 1.0 (0.8–1.4) | 0.83 | |||
| 2/6 | 27 | 0.8 (0.5–1.4) | 0.52 | |||
| Age | ||||||
| <18 | 26 | 1.0 (ref) | 21 | 1.0 (ref) | ||
| 18–34 | 77 | 1.8 (0.9–3.6) | 0.12 | 20 | 0.6 (0.3–1.5) | 0.32 |
| 35+ | 286 | 2.7 (1.4 (5.5) | <0.01 | 85 | 0.3 (0.1–0.8) | 0.01 |
| Disease Risk | ||||||
| Standard risk* | 227 | 1.0 (ref) | 84 | 1.0 (ref) | ||
| High risk | 162 | 1.5 (1.2–2.0) | <0.01 | 42 | 1.2 (0.8–2.1) | 0.40 |
| Patient CMV | ||||||
| Negative* | 158 | 1.0 (ref) | NS | NS | NS | |
| Positive | 231 | 1.5 (1.2–2.0) | <0.01 | NS | NS | NS |
| aGVHD | ||||||
| No | 235 | 1.0 (ref) | 1.0 (ref) | |||
| Yes | 154 | 0.6 (0.5–0.8) | <0.01 | 0.9 (0.6–1.5) | 0.79 | |
| Non-Relapse Mortality£ | ||||||
| HLA-C match score | ||||||
| 4/4* | 29 | 1.0 (ref) | 48 | 1.0 (ref) | ||
| 3/4 | 77 | 3.8 (0.8–16.6) | 0.08 | 31 | 0.5 (0.2–1.6) | 0.24 |
| 2/4 | 171 | 6.3 (1.5–26.7) | 0.01 | 40 | 1.3 (0.5–3.2) | 0.53 |
| 1/4 | 59 | 6.2 (1.4–26.7) | 0.01 | 7** | 1.1 (0.2–5.6) | 0.95 |
| 0/4 | 53 | 6.5 (1.5–28.2) | 0.01 | |||
| Worst HLA-A,-B and -DRB1 Match | ||||||
| 6/6* | 24 | 1.0 (ref) | ||||
| 5/6 | 102 | 1.1 (0.4–3.4) | 0.82 | |||
| 4/6* | 256 | 1.0 (ref) | ||||
| 3/6 | 106 | 0.8 (0.5–1.3) | 0.46 | |||
| 2/6 | 27 | 0.9 (0.5–2.0) | 0.89 | |||
| Age | ||||||
| <18 | 26 | 1.0 (ref) | NS | NS | NS | |
| 18–34 | 77 | 1.6 (0.7–3.6) | 0.22 | NS | NS | NS |
| 35+ | 286 | 2.1 (1.0–4.3) | 0.05 | NS | NS | NS |
| Disease Risk | ||||||
| Standard risk* | 227 | 1.0 (ref) | 84 | 1.0 (ref) | ||
| High risk | 162 | 2.1 (1.4–3.0) | <0.01 | 42 | 1.7 (0.8–3.7) | 0.15 |
| Patient CMV | ||||||
| Negative* | 158 | 1.0 (ref) | NS | NS | NS | |
| Positive | 231 | 1.6 (1.1–2.3) | 0.02 | NS | NS | NS |
| Conditioning | ||||||
| MA* | 123 | 1.0 (ref) | 54 | 1.0 (ref) | ||
| RIC | 266 | 0.3 (0.2–0.5) | <0.01 | 72 | 0.4 (0.2–1.0) | 0.05 |
Abbreviations: HLA, human leukocyte antigen; dUCB, double umbilical cord blood; N, number of patients; CI, confidence interval; CMV, cytomegalovirus; MA, myeloablative conditioning; RIC, reduced intensity conditioning; GVHD, graft-vs-host disease.
*
Reference group
**
Combined 0 and 1 HLA-C matching score
&
Overall survival and disease-free survival among 4/6 +4–6/6 were stratified by transplant center and intensity of the conditioning regimen, while for 5/6+-5–6/6 these outcomes were stratified by transplant center.
£
Stratified by transplant center