Table 1.
Recipient, donor, and transplant characteristics.
| Patients (n=356) | CNI/mTORi-based (n=145) | Serotherapy (n=82) | PTCy-based (n=58) | TCD (n=46) | UCB (n=25) | p-value | |
|---|---|---|---|---|---|---|---|
| Male, n (%) | 215 (60%) | 82 (56%) | 61 (74%) | 28 (49%) | 29 (63%) | 15 (60%) | p=0.02 |
| Age at HCT, median (range) | 31 (3–71) | 38.5 (8–71) | 28 (4–68) | 22 (6–66) | 30 (6–70) | 20 (3–52) | p<0.0001 |
| Diagnosis, n (%) | p<0.0001 | ||||||
| Malignancy | 178 (50%) | 112 (77%) | 9 (11%) | 10 (17%) | 44 (96%) | 2 (8%) | |
| Primary Immunodeficiency | 97 (27%) | 20 (14%) | 29 (35%) | 48 (83%) | 0 | 1 (4%) | |
| Hemoglobinopathy/Thalassemia | 44 (12%) | 0 | 44 (54%) | 0 | 0 | 0 | |
| Aplastic Anemia | 37 (10%) | 13 (9%) | 0 | 0 | 2 (4%) | 22 (88%) | |
| Intensity of conditioning, n (%) | p<0.0001 | ||||||
| NMA/RIC | 196 (55%) | 92 (63%) | 53 (65%) | 15 (26%) | 12 (26%) | 24 (96%) | |
| Myeloablative | 160 (45%) | 53 (37%) | 29 (35%) | 43 (74%) | 34 (74%) | 1 (4%) | |
| Graft source, n (%) | p<0.001 | ||||||
| PBSC | 264 (74%) | 118 (81%) | 80 (98%) | 20 (35%) | 46 (100%) | 0 | |
| Bone Marrow | 67 (19%) | 27 (19%) | 2 (2%) | 38 (65%) | 0 | 0 | |
| UCB or CD34+ selected haplo+UCB | 25 (7%) | 0 | 0 | 0 | 0 | 25 (100%) | |
| Donor type, n (%) | p<0.0001 | ||||||
| HLA-matched related | 183 (51%) | 107 (74%) | 33 (40%) | 6 (10%) | 38 (83%) | 0 | |
| HLA-matched unrelated | 84 (24%) | 33 (23%) | 32 (39%) | 12 (21%) | 7 (15%) | 0 | |
| HLA-haploidentical | 56 (16%) | 0 | 15 (18%) | 40 (69%) | 0 | 0 | |
| UCB or CD34+ selected haplo+UCB | 25 (7%) | 0 | 0 | 0 | 0 | 25 (100%) | |
| HLA-mismatched unrelated | 8 (2%) | 5 (3%) | 2 (2%) | 0 | 1 (2%) | 0 | |
| Donor age, median (range)a | 32 (4–71) | 38 (5–71) | 30 (4–67) | 34 (5–65) | 30 (12–69) | n/a | p=0.02 |
| Female --> male HCT, n (%) | 89 (25%) | 32 (22%) | 29 (35%) | 8 (14%) | 11 (24%) | 9 (36%) | p=0.03 |
| At-risk for post-HCT CMV infectionb | 263 (74%) | 118 (81%) | 55 (67%) | 43 (74%) | 30 (65%) | 17 (68%) | NS |
| D/R CMV serostatus, n (%)c | p<0.001 | ||||||
| +/+ | 161 (45%) | 78 (54%) | 33 (40%) | 27 (47%) | 22 (48%) | 0 | |
| −/− | 88 (24%) | 27 (18%) | 26 (32%) | 12 (21%) | 15 (33%) | 8 (32%) | |
| −/+ | 67 (19%) | 23 (16%) | 14 (17%) | 7 (12%) | 6 (13%) | 17 (68%) | |
| +/− | 31 (9%) | 17 (12%) | 8 (10%) | 5 (9%) | 1 (2%) | 0 | |
| T-cell dose x 107/kg, median (IQR)d | 10.5 (2.0–22.7) | 12.1 (3.9–19.3) | 31.5 (21.9–38.8) | 6.17 (3.8–20) | 0.09 (0.06–0.13) | 0.74 (0.5–1.1) | p<0.0001 |
Abbreviations: CNI, calcineurin inhibitor; mTORi, mammalian target of rapamycin inhibitor; PTCy, post-transplantation cyclophosphamide; HCT, hematopoietic cell transplantation; NMA, non-myeloablative; RIC, reduced intensity conditioning; PBSC, peripheral blood stem cells; UCB, umbilical cord blood; HLA, human leukocyte antigen; D/R, donor/recipient; CMV, cytomegalovirus; IQR, interquartile range; TCD, ex vivo T-cell depletion
Excluding UCB and haplo-UCB since engrafting cells are UCB
Recipients were considered at-risk for CMV infection if either donor or recipient were CMV-seropositive, including the haplo donor of haplo-UCB HCTs.
D/R unknown for 10 (3%) recipients; for HCT using haplo+UCB donors, UCB was presumed CMV-seronegative and haplo donor CMV serostatus was used to determine at-risk designations for recipients, as it was presumed that a CMV-seropositive CD34+ selected haplo product could transmit CMV to the recipient. However, haplo donor serostatus was not used to designate donor CMV serostatus for use as a variable for CMV infection risk analyses, as the T-cell immunity was provided by the UCB donor.
T-cell dose unknown in 18 (5%) recipients