Table 3. Adjusted HRs of Late All-Cause, Relapse-Related, and Non–Relapse-Related Mortality Among 1388 Individuals Who Lived 2 Years or More After Allogeneic BMT in Childhood.
Variable | All-Cause Mortality | Relapse-Related Mortality | Non–Relapse-Related Mortality | |||
---|---|---|---|---|---|---|
Adjusted HR (95% CI) | P Value | Adjusted HR (95% CI) | P Value | Adjusted HR (95% CI) | P Value | |
Sex | ||||||
Male | 0.93 (0.74-1.18) | .60 | 1.26 (0.74-2.25) | .40 | 0.94 (0.70-1.27) | .70 |
Female | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
Race/ethnicity | ||||||
Non-Hispanic white | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
Non-Hispanic black | 1.53 (0.91-2.57) | .10 | 0.75 (0.11-2.66) | .70 | 1.62 (0.81-3.01) | .10 |
Hispanic | 0.86 (0.59-1.25) | .40 | 0.64 (0.23-1.48) | .30 | 1.00 (0.63-1.56) | .99 |
Other | 1.24 (0.78-1.95) | .40 | 1.03 (0.31-2.62) | >.99 | 1.30 (0.71-2.21) | .40 |
Unknown | 0.30 (0.04-2.17) | .20 | NA | NA | 0.51 (0.03-2.37) | .50 |
Age at BMT, ya | 1.03 (1.01-1.05) | .004 | 1.03 (0.98-1.07) | .20 | 1.03 (1.00-1.06) | .03 |
Year of BMT | ||||||
<1990 | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
1990-1999 | 0.64 (0.47-0.89) | .008 | 0.74 (0.38-1.43) | .40 | 0.67 (0.44-1.01) | .06 |
2000-2010 | 0.49 (0.31-0.76) | .002 | 0.67 (0.28-1.51) | .30 | 0.46 (0.25-0.80) | .01 |
Type of donor | ||||||
Related | 1 [Reference] | |||||
Unrelated | 1.06 (0.76-1.70) | .74 | 0.71 (0.34-1.43) | .40 | 1.30 (0.86-1.95) | .20 |
Source of stem cells | ||||||
Bone marrow | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
Cord blood | 0.83 (0.52-1.34) | .50 | 0.67 (0.22-1.82) | .40 | 0.96 (0.53-1.68) | .90 |
PBSC | 1.77 (1.01-3.11) | .05 | 0.96 (0.24-3.14) | .90 | 2.39 (1.21-4.65) | .01 |
Primary diagnosis | ||||||
ALL | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
AML or MDS | 0.72 (0.53-0.99) | .04 | 0.39 (0.18-0.80) | .01 | 0.79 (0.53-1.16) | .20 |
Inborn errors of metabolism | 0.98 (0.61-1.57) | .90 | 1.27 (0.49-3.28) | .60 | 0.84 (0.45-1.52) | .50 |
Severe aplastic anemia | 0.33 (0.19-0.57) | <.001 | 0.09 (0.01-0.48) | .03 | 0.36 (0.17-0.71) | .004 |
Fanconi anemiab | 0.49 (0.26-0.94) | .03 | NA | NA | 0.70 (0.32-1.43) | .40 |
Chronic myelogenous leukemia | 0.53 (0.32-0.88) | .02 | 0.24 (0.04-0.85) | .06 | 0.60 (0.31-1.08) | .10 |
Other malignant diseasec | 0.70 (0.39-1.25) | .20 | 0.87 (0.25-2.35) | .80 | 0.82 (0.39-1.58) | .60 |
Immune disorders | 0.32 (0.14-0.74) | .006 | 0.24 (0.01-1.38) | .20 | 0.14 (0.02-0.48) | .009 |
Sickle cell disease or thalassemia | 0.46 (0.13-1.56) | .20 | 0.74 (0.04-4.97) | .80 | 0.47 (0.07-1.72) | .30 |
Other nonmalignant diseased | 1.03 (0.43-2.44) | >.99 | 0.71 (0.04-3.90) | .70 | 0.79 (0.19-2.26) | .70 |
Disease status at BMT | ||||||
Standard risk of relapsee | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
High risk of relapse | 1.95 (1.45-2.63) | <.001 | 1.57 (0.80-2.99) | .20 | 2.05 (1.41-2.94) | <.001 |
Conditioning regimen | ||||||
Total body irradiation plus cyclophosphamide | 1 [Reference] | 1 [Reference] | 1 [Reference] | |||
Busulfan plus cyclophosphamide | 0.62 (0.41-0.95) | .03 | 0.63 (0.27-1.47) | .30 | 0.71 (0.41-1.19) | .20 |
Others | 0.88 (0.64-1.21) | .40 | 0.73 (0.36-1.44) | .30 | 0.93 (0.62-1.38) | .70 |
Abbreviation: ALL, acute lymphoblastic leukemia; AML, acute myeloid leukemia; BMT, blood or marrow transplantation; MDS, myelodysplastic syndrome; HR, hazard ratio; NA, not applicable; PBSC, peripheral blood stem cells.
Age included in the model as a continuous variable.
Includes Fanconi anemia, Diamond Blackfan anemia, and Shwachman-Diamond syndrome.
Includes 27 with non-Hodgkin lymphoma, 7 with Hodgkin lymphoma, 8 with neuroblastoma, 2 with unspecified leukemia, and 20 with histiocytosis.
Includes 1 with megakaryocytosis, 3 with dyskeratotis congenita, 8 with epidermolysis bullosa, 1 with Kostmann agranulocytosis, 11 with osteopetrosis, and 1 with paroxysmal nocturnal hemoglobinuria.
First or second complete remission after acute leukemia or lymphoma or first chronic phase of chronic myelogenous leukemia or severe aplastic anemia, all others high risk.