Table 3.
Multivariable Hazard of Relapse in AYA (Adolescents and Young Adults) by Time of Relapse
| Relapse During Therapy1 (All AYA: n=93) | Relapse After Completion of Therapy1 (AYA Who Completed Therapy: n=42) | |||||
|---|---|---|---|---|---|---|
| HR | 95%CI | p-value | HR | 95%CI | p-value | |
| Duration of Therapy | ||||||
| Duration of Maintenance2 | 0.9 | 0.7–1.2 | 0.6 | 0.7 | 0.6–0.8 | <0.001 |
| Duration of Consolidation2 | 0.9 | 0.7–1.2 | 0.6 | 0.8 | 0.6–1.0 | 0.03 |
| Oncology Service and Therapy Types | ||||||
| Pediatric Oncology + Pediatric Therapy | 1.0 | -- | -- | 1.0 | -- | -- |
| Adult Oncology + Adult Therapy | 1.9 | 0.7–5.2 | 0.2 | 0.8 | 0.1–4.7 | 0.8 |
| Mixed Oncology + Mixed Therapy | 0.3 | 0.1–1.5 | 0.2 | 0.3 | 0.04–1.9 | 0.2 |
| Insurance and Socioeconomic Status (SES) | ||||||
| Private Insurance + High SES | 1.0 | -- | -- | 1.0 | -- | -- |
| Public Insurance + Low SES | 0.5 | 0.2–1.4 | 0.2 | 6.8 | 0.8–60.8 | 0.09 |
| Mixed Profile | 0.6 | 0.2–1.7 | 0.4 | 1.2 | 0.1–12.5 | 0.9 |
| Race and Ethnicity | ||||||
| Non-Hispanic White | 1.0 | -- | -- | 1.0 | -- | -- |
| Non-White Race/ Ethnicity | 2.2 | 1.0–4.8 | 0.05 | 0.2 | 0.03–1.9 | 0.2 |
| Clinical Trial Enrollment | ||||||
| Enrolled on Clinical Trial | 1.0 | -- | -- | 1.0 | -- | -- |
| Not Enrolled on Clinical Trial | 2.6 | 1.0–6.3 | 0.04 | 1.1 | 0.2–6.0 | 0.9 |
| Gender | ||||||
| Female | 1.0 | -- | -- | 1.0 | -- | -- |
| Male | 0.8 | 0.4–1.7 | 0.6 | 1.3 | 0.3–5.1 | 0.7 |
| Age | ||||||
| Age in Years | 1.00 | 1.0–1.1 | 0.5 | 1.0 | 0.9–1.1 | 1.0 |
| Time | ||||||
| Time in Months2 | 1.1 | 0.8–1.4 | 0.7 | 0.98 | 0.96–1.0 | 0.03 |
| Clinical Prognosticators | ||||||
| WBC <50K | 1.0 | -- | -- | 1.0 | -- | -- |
| WBC >50K | 1.6 | 0.8–3.1 | 0.2 | 7.9 | 1.6–38.8 | 0.01 |
| Precursor B-Cell | 1.0 | -- | -- | 1.0 | -- | -- |
| T-Cell | 1.3 | 0.6–2.6 | 0.5 | 0.3 | 0.04–1.6 | 0.2 |
| No high-risk cytogenetics identified | 1.0 | -- | -- | 1.0 | -- | -- |
| High risk cytogenetic profile | 1.2 | 0.6–2.6 | 0.7 | |||
| M1 marrow at End of Induction3 | 1.0 | -- | -- | 1.0 | -- | -- |
| M2-M3 marrow at End of Induction3 | 2.0 | 0.9–4.9 | 0.1 | 1.2 | 0.2–6.6 | 0.9 |
| CNS Negative | 1.0 | -- | -- | |||
| CNS Positive | 8.6 | 2.1–35.0 | 0.003 | |||
Adjusted discrete time survival analysis, modeling hazard of relapse with death due to non-relapse causes and date of last contact as censoring events. Bolded values represent statistically significant findings. On-therapy model adjusted for AYA*time interaction.
These variables were modeled as time-varying covariates. Time at risk represents: (a) months from CR1 in the model calculating hazard of relapse on therapy; (b) months from completion of therapy in the model calculating hazard of relapse after completing therapy. HRs represent each additional month of time from remission/ completion of therapy, or each additional month of therapy.
Patients with M2-M3 marrows at the end of induction were compared to patients who either (a) had M1 marrows at the end of induction or (b) did not have a documented end of induction marrow, but the first marrow documented after initiation of treatment (>36 days) was M1.