Table III.
Univariate analysis of factors for outcomes after second HCT
| Variables | Progression Free Survival | Overall Survival | Progression | Non Relapse Mortality | |||||
|---|---|---|---|---|---|---|---|---|---|
| N vs N | HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | HR (95% CI) | p value | |
| Second HCT before vs after 2011 | 46 vs 45 | 1.4 (0.8–2.4) | 0.2 | 1.2(0.75–2.02) | 0.4 | 0.9 (0.4–1.6) | 0.6 | 1.1 (0.4–2.8) | 0.9 |
| Age at second HCT ≥60 vs <60 years | 16 vs 75 | 1.5 (0.7–3.6) | 0.3 | 1.5 (0.7–3.3) | 0.3 | 0.9 (0.3–2.9) | 0.8 | 3.8 (1.2–12) | 0.02 |
| Age at second HCT ≥40 vs <40 years | 54 vs 37 | 1.7 (0.96–2.9) | 0.07 | 1.5 (0.9–2.5) | 0.09 | 1.4 (0.7–2.6) | 0.4 | 1.4 (0.5–3.7) | 0.5 |
| Female vs Male | 43 vs 48 | 1.5 (0.9–2.6) | 0.1 | 1.2 (0.7–1.9) | 0.5 | 0.8 (0.4–1.6) | 0.5 | 0.9 (0.3–2.4) | 0.8 |
| HCT-CI ≥2 vs 0–1 | 46 vs 45 | 1.8 (1.0–3.2) | 0.05 | 1.7 (0.99–2.9) | 0.05 | 1.01 (0.5–1.9) | 0.9 | 1.3 (0.5–3.4) | 0.6 |
| Primary vs t-AML | 85 vs 6 | 1.7 (0.7–4.3) | 0.3 | 1.9 (0.8–4.4) | 0.1 | 1.4 (0.4–4.6) | 0.6 | 0.9 (0.1–5.6) | 0.9 |
| Response before second HCT | |||||||||
| CR/CRi vs Persistent disease* | 56 vs 22 | 0.8 (0.4–1.5) | 0.5 | 0.7 (0.4–1.2) | 0.2 | 0.6 (0.3–1.2) | 0.1 | 1.5 (0.4–5.4) | 0.5 |
| Duration of remission after first HCT | |||||||||
| ≤6 months vs >6 months | 28 vs 63 | 1.4 (0.8–2.4) | 0.3 | 1.4 (0.8–2.4) | 0.2 | 0.6 (0.3–1.2) | 0.1 | 1.5 (0.4–5.4) | 0.5 |
| Haploidentical vs another donor | 19 vs 72 | 0.8 (0.4–1.6) | 0.5 | 0.86 (0.5–1.6) | 0.6 | 0.8 (0.4–1.7) | 0.6 | 0.9 (0.2–3.2) | 0.9 |
| Haploidentical vs MUD or MRD | 19 vs 32 / 37 |
0.8 (0.4–1.6) | 0.5 | 0.9 (0.5–1.6) | 0.7 | 0.8 (0.4–1.7) | 0.6 | 0.9 (0.3–3.3) | 0.9 |
| MUD vs MRD | 32 vs 37 | 0.7 (0.4–1.4) | 0.3 | 0.8 (0.5–1.5) | 0.5 | 0.9 (0.5–1.9) | 0.9 | 2.5 (0.7–8.2) | 0.1 |
| Same vs different donor | 43 vs 48 | 0.9 (0.5–1.5) | 0.7 | 0.8 (0.5–1.3) | 0.3 | 1.1 (0.6–2.2) | 0.7 | 0.5 (0.2–1.4) | 0.2 |
| MAC vs RIC for second HCT | 20 vs 71 | 1.1 (0.6–2.1) | 0.6 | 1.3 (0.7–2.3) | 0.4 | 1.2 (0.6–2.6) | 0.6 | 1.1 (0.4–3.4) | 0.8 |
| Graft source | |||||||||
| Peripheral blood | 71 | 1.0 (0.6–1.8) | 0.9 | 0.8 (0.4–1.6) | 0.6 | 1.6 (0.7–3.6) | 0.3 | 0.6 (0.2–1.7) | 0.3 |
| Bone marrow | 19 | Ref. | Ref. | Ref. | Ref. | ||||
| Cord blood | 1 | Ref. | Ref. | Ref. | Ref. | ||||
| GVHD prophylaxis for second HCT | |||||||||
| PTCy vs no PTCy | 25 vs 66 | 0.6 (0.3–1.2) | 0.2 | 0.7 (0.4–1.2) | 0.2 | 0.8 (0.3–1.6) | 0.4 | 0.6 (0.2–2.2) | 0.5 |
| Acute GVHD grade 3–4 after first HCT | 4 vs 87 | 2.8 (0.9–9) | 0.09 | 2.2 (0.7–6.9) | 0.2 | 0.9 (0.4–2.2) | 0.9 | 1.7 (0.2–15) | 0.6 |
| Chronic GVHD after first HCT | 17 vs 74 | 3.03 (1.7–5.5) | <0.001 | 2.6 (1.5–4.8) | 0.001 | 0.9 (0.4–2.4) | 0.9 | 1.7 (0.5–5.2) | 0.4 |
| Cytogenetic risk per ELN at time of second HCT | |||||||||
| Adverse vs intermediate | 18 vs 61 | 1.3 (0.7–2.3) | 0.4 | 0.9 | 0.4 | 2.0 (0.9–4.2) | 0.06 | 0.5 (0.1–2.5) | 0.4 |
Abbreviations: HCT=hematopoietic cell transplantation; HR=hazards ratio; MRD=measurable residual disease; CI=confidence interval; t-AML=therapy related acute myeloid leukemia; CR=complete response; CRi=complete response with incomplete hematologic recovery; MRD=matched related donor; MUD=matched unrelated donor; CB=cord blood; MAC=myeloablative conditioning; RIC=reduced intensity conditioning; ELN=European Leukemia Network; GVHD=graft-versus-host disease; PTCy=posttransplant cyclophosphamide.
Unevaluable patients excluded (unevaluable include patients with 1) aplastic marrow insufficient for analysis and/or 2) patients who received a salvage treatment following the most recent disease evaluation.