Table 1.
Comparison of clinical characteristics among the four patient groups.
| Characteristic | BSI-VEP Total n(%) | BSI-LEP Total n(%) | BSI-Both Total n(%) | No BSI Total n(%) | P-Value |
|---|---|---|---|---|---|
| Number of patients | 1,492 | 824 | 340 | 4,472 | |
| Number of centers | 165 | 138 | 105 | 177 | |
| Gender, Male | 836 (56) | 446 (54) | 187 (55) | 2,483 (56) | 0.840 |
| Age, years median (range) | 42 (<1–75) | 46 (<1–79) | 42 (1–74) | 49 (<1–78) | <0.001 |
| ≤10 | 214 (14) | 93 (11) | 56 (16) | 405 ( 9) | |
| 11–20 | 179 (12) | 98 (12) | 40 (12) | 338 ( 8) | |
| 21–30 | 162 (11) | 84 (10) | 31 ( 9) | 430 (10) | |
| 31–40 | 163 (11) | 87 (11) | 30 ( 9) | 452 (10) | |
| 41–50 | 222 (15) | 120 (15) | 58 (17) | 725 (16) | |
| 51–60 | 327 (22) | 175 (21) | 75 (22) | 1,064 (24) | |
| >60 | 225 (15) | 167 (20) | 50 (15) | 1,058 (24) | |
| KPS | 0.915 | ||||
| <90 | 470 (32) | 265 (32) | 103 (30) | 1,392 (31) | |
| 90–100 | 995 (67) | 541 (66) | 233 (69) | 2,996 (67) | |
| Missing | 27 ( 2) | 18 ( 2) | 4 ( 1) | 84 ( 2) | |
| HCT-CI | 0.530 | ||||
| 0 | 650 (44) | 353 (43) | 140 (41) | 1,927 (43) | |
| 1 | 224 (15) | 114 (14) | 55 (16) | 649 (15) | |
| 2 | 159 (11) | 91 (11) | 44 (13) | 536 (12) | |
| ≥3 | 433 (29) | 321 (30) | 95 (28) | 1,263 (28) | |
| Missing | 26 ( 2) | 13 ( 2) | 6 ( 2) | 97 ( 2) | |
| Conditioning intensity | <0.001 | ||||
| Myeloablative | 1,207 (81) | 617 (75) | 276 (81) | 3,149 (70) | |
| RIC/NMA | 285 (19) | 207 (25) | 64 (19) | 1,323 (30) | |
| TBI dose | <0.001 | ||||
| No TBI | 664 (45) | 430 (52) | 156 (46) | 2,480 (55) | |
| ≤1200 cGy | 454 (30) | 265 (32) | 110 (32) | 1,297 (29) | |
| >1200 cGy | 374 (25) | 129 (16) | 74 (22) | 695 (16) | |
| Disease status at HCT | <0.001 | ||||
| AML/ALL Early | 596 (40) | 325 (39) | 132 (39) | 1,908 (43) | |
| AML/ALL Intermediate | 378 (25) | 192 (23) | 88 (26) | 884 (20) | |
| AML/ALL Advanced | 254 (17) | 115 (14) | 57 (17) | 613 (14) | |
| MDS Early | 95 ( 6) | 70 ( 8) | 26 ( 8) | 415 ( 9) | |
| MDS Advanced | 156 (10) | 119 (14) | 34 (10) | 630 (14) | |
| Missing | 13 (<1) | 3 (<1) | 3 (<1) | 22 (<1) | |
| Time to AlloHCT, median (range), months | 7 (<1–313) | 7 (<1–173) | 7 (1–224) | 6 (<1–291) | 0.059 |
| Donor age, in decades | <0.001 | ||||
| UCB | 593 (40) | 210 (25) | 113 (33) | 918 (21) | |
| Related donor | 366 (25) | 211 (26) | 87 (26) | 1,454 (33) | |
| 18–20 | 43 ( 3) | 28 ( 3) | 8 ( 2) | 148 ( 3) | |
| 21–30 | 193 (13) | 157 (19) | 43 (13) | 857 (19) | |
| 31–40 | 118 ( 8) | 98 (12) | 34 (10) | 479 (11) | |
| 41–50 | 96 ( 6) | 63 ( 8) | 38 (11) | 321 ( 7) | |
| 51–60 | 28 ( 2) | 24 ( 3) | 4 ( 1) | 97 ( 2) | |
| Missing | 55 ( 4) | 33 ( 4) | 13 ( 4) | 198 ( 4) | |
| Donor-recipient sex match | 0.799 | ||||
| Male-Male | 522 (35) | 269 (33) | 108 (32) | 1,554 (35) | |
| Male-Female | 359 (24) | 231 (28) | 88 (26) | 1,128 (25) | |
| Female-Male | 310 (21) | 174 (21) | 78 (23) | 909 (20) | |
| Female-Female | 292 (20) | 145 (18) | 63 (19) | 851 (19) | |
| Missing | 9 (<1) | 5 (<1) | 3 (<1) | 30 (<1) | |
| Donor-recipient CMV status | 9 (<1) | 5 (<1) | 3 (<1) | 30 (<1) | <0.001 |
| +/+ | 291 (20) | 179 (22) | 77 (23) | 1,043 (23) | |
| +/− | 98 ( 7) | 49 ( 6) | 27 ( 8) | 418 ( 9) | |
| −/+ | 646 (43) | 328 (40) | 142 (42) | 1,627 (36) | |
| −/− | 441 (30) | 256 (31) | 85 (25) | 1,307 (29) | |
| Both missing | 16 ( 1) | 12 ( 1) | 9 ( 3) | 77 ( 2) | |
| Graft type | <0.001 | ||||
| Bone marrow | 239 (16) | 114 (14) | 52 (15) | 662 (15) | |
| PBSC | 660 (44) | 500 (61) | 175 (51) | 2,892 (65) | |
| Umbilical Cord blood | 593 (40) | 210 (25) | 113 (33) | 918 (21) | |
| Donor/recipient HLA match | <0.001 | ||||
| Umbilical Cord blood | 593 (40) | 210 (25) | 113 (33) | 918 (21) | |
| HLA-identical siblings | 337 (23) | 196 (24) | 78 (23) | 1,379 (31) | |
| Matched/Mismatched related | 5 (<1) | 2 (<1) | 3 (<1) | 20 (<1) | |
| Haplo-identical | 24 ( 2) | 13 ( 2) | 6 ( 2) | 55 ( 1) | |
| 8/8 unrelated | 382 (26) | 277 (34) | 85 (25) | 1,558 (35) | |
| 7/8 unrelated | 114 ( 8) | 98 (12) | 42 (12) | 401 ( 9) | |
| <=6/8 unrelated | 10 (<1) | 5 (<1) | 7 ( 2) | 27 (<1) | |
| Unrelated (HLA match information missing) | 27 ( 2) | 23 ( 3) | 6 ( 2) | 114 ( 3) | |
| ATG/Alemtuzumab as conditioning/GVHD prophy | 0.240 | ||||
| ATG alone | 442 (30) | 244 (30) | 102 (30) | 1,367 (31) | |
| Alemtuzumab alone | 36 ( 2) | 9 ( 1) | 11 ( 3) | 89 ( 2) | |
| No ATG or Alemtuzumab | 1,014 (68) | 571 (69) | 227 (67) | 3,016 (67) | |
| GVHD prophylaxis | <0.001 | ||||
| CSA/TAC + MTX ± others | 659 (44) | 411 (50) | 159 (48) | 2,398 (54) | |
| CSA/TAC + MMF ± others | 541 (36) | 297 (36) | 128 (38) | 1,393 (31) | |
| CSA/TAC + others | 166 (11) | 66 ( 8) | 31 ( 9) | 392 ( 9) | |
| CSA/TAC alone | 52 ( 3) | 20 ( 2) | 9 ( 3) | 145 ( 3) | |
| SIRO +/− others (Not TAC/CSA) | 3 (<1) | 1 (<1) | 0 | 15 (<1) | |
| ATG/ Alemtuzumab only | 0 | 0 | 0 | 7 (<1) | |
| Ex vivo T-cell depletion | 29 ( 2) | 10 ( 1) | 2 (<1) | 26 (<1) | |
| CD34 selection | 19 ( 1) | 2 (<1) | 5 ( 1) | 48 ( 1) | |
| Cyclophosphamide | 20 ( 1) | 15 ( 2) | 5 ( 1) | 81 ( 2) | |
| Other GVHD prophylaxis | 3 (<1) | 2 (<1) | 1 (<1) | 17 (<1) | |
| G-CSF, GM-CSF use, yes | 901 (60) | 498 (60) | 205 (60) | 2,379 (53) | <0.001 |
| Supplemental IVIG, yes | 712 (48) | 389 (47) | 191 (56) | 1,766 (39) | <0.001 |
| Year of AlloHCT | <0.001 | ||||
| 2008 | 448 (30) | 248 (30) | 121 (36) | 1,194 (27) | |
| 2009 | 410 (27) | 240 (29) | 97 (29) | 1,073 (24) | |
| 2010 | 284 (19) | 158 (19) | 56 (16) | 837 (19) | |
| 2011 | 177 (12) | 98 (12) | 42 (12) | 642 (14) | |
| 2012 | 173 (12) | 80 (10) | 24 ( 7) | 726 (16) |
Abbreviations: AlloHCT, allogeneic hematapoietic cell transplantation; ALC, absolute lymphocyte count; ANC, absolute neutrophil count; ATG, anti-thymocyte globulin; BSI, blood stream infections; CMV, cytomegalovirus; CSA, cyclosporine; G-CSF, granulocyte-colony forming factor; GM-CSF, granulocyte,monocyte- colony forming factor; GVHD, graft-versus-host disease; HCT-CI, Hematopoietic cell transplant comorbidity index; HLA, human leukocyte antigens; IVIG, intravenous immunoglobulin; KPS, Karnofsky Performance score; LEP, late early phase; MMF, mycophenolate mofetil; MTX, methotrexate; NMA, non-myeloablative; PBSC, peripheral blood stem cells; RIC, reduced-intensity conditioning; SIRO, sirolimus; TAC, tacrolimus; TBI, total body irradiation WBC, white blood cells; ; VEP, very early phase