Table 4.
Multivariable analysis for overall survival examining the effect of non-infectious pulmonary toxicity (NPT) after allogeneic transplantation
| Variable | N | HR | 95% CI | P-value |
|---|---|---|---|---|
| Non-infectious Pulmonary Toxicity | ||||
| No | 19641 | 1 | <.0001 | |
| Yes | 1828 | 4.187 | 3.78II-IV.635 | <.0001 |
| Disease group | ||||
| AML | 8001 | 1 | <.0001 | |
| ALL | 2505 | 0.912 | 0.855–0.974 | 0.0059 |
| CML/MDS/MPN | 6745 | 0.93 | 0.887–0.976 | 0.0033 |
| Lymphomas/CLL/PCDs | 3121 | 0.782 | 0.729–0.84 | <.0001 |
| Non-malignant diseases | 1097 | 0.56 | 0.471–0.666 | <.0001 |
| Age Group | ||||
| 18–39 | 5062 | 1 | <.0001 | |
| 40–64 | 12036 | 1.343 | 1.274–1.417 | <.0001 |
| ≥65 | 4371 | 1.638 | 1.524–1.761 | <.0001 |
| Race | ||||
| Caucasian | 15914 | 1 | 0.0011 | |
| African-American | 1643 | 1.19 | 1.081–1.311 | 0.0004 |
| Asian/Pacific Islander | 1336 | 0.979 | 0.851–1.127 | 0.769 |
| Hispanic | 1800 | 1.054 | 0.971–1.145 | 0.2099 |
| KPS | ||||
| >90% | 3849 | 1 | 0.0001 | |
| ≤90% | 17221 | 1.187 | 1.096–1.286 | <.0001 |
| History of smoking | ||||
| No | 12170 | 1 | <.0001 | |
| Yes | 8499 | 1.108 | 1.063–1.153 | <.0001 |
| HCT-CI (minus pulmonary) | ||||
| 0 | 8636 | 1 | <.0001 | |
| 1 | 5264 | 1.105 | 1.047–1.167 | 0.0003 |
| 2 | 2311 | 1.214 | 1.129–1.305 | <.0001 |
| 3 | 2332 | 1.225 | 1.135–1.322 | <.0001 |
| ≥4 | 2429 | 1.45 | 1.351–1.556 | <.0001 |
| Pulmonary comorbidity | ||||
| None | 12624 | 1 | <.0001 | |
| Severe | 3220 | 1.27 | 1.194–1.351 | <.0001 |
| Moderate | 5144 | 1.031 | 0.975–1.09 | 0.2806 |
| Prior autologous transplant | ||||
| No | 20202 | 1 | <.0001 | |
| Yes | 1267 | 1.226 | 1.136–1.323 | <.0001 |
| GVHD prophylaxis | ||||
| Ex-vivo T-cell depletion / CD34 selection | 687 | 1 | <.0001 | |
| PtCy +/− other(s) | 2235 | 0.989 | 0.782–1.251 | 0.9277 |
| CNI+MMF | 5999 | 1.148 | 0.932–1.415 | 0.1933 |
| CNI+MTX | 9762 | 0.974 | 0.777–1.22 | 0.8164 |
| CNI+/−other | 2118 | 1.017 | 0.803–1.29 | 0.8863 |
| Year of transplant | ||||
| 2008 to 2010 | 6379 | 1 | <.0001 | |
| 2011 to 2013 | 4471 | 0.824 | 0.772–0.879 | <.0001 |
| ≥2014 | 10619 | 0.739 | 0.693–0.787 | <.0001 |
| Donor type, Graft source | ||||
| HLA-identical sibling BM | 636 | 1 | <.0001 | |
| HLA-identical sibling PB | 4925 | 1.284 | 1.089–1.513 | 0.0029 |
| Haplo-related BM | 846 | 1.407 | 1.167–1.697 | 0.0003 |
| Haplo-related PB | 1814 | 1.543 | 1.281–1.86 | <.0001 |
| Matched unrelated BM | 1436 | 1.341 | 1.151–1.563 | 0.0002 |
| Matched unrelated PB | 6826 | 1.339 | 1.147–1.564 | 0.0002 |
| Mismatched unrelated BM | 366 | 1.778 | 1.458–2.169 | <.0001 |
| Mismatched unrelated PB | 1521 | 1.644 | 1.373–1.967 | <.0001 |
| Cord Blood | 2904 | 1.711 | 1.376–2.127 | <.0001 |
Abbreviations: OS = overall survival; NPT = non-infectious pulmonary toxicity; alloHCT = allogeneic hematopoietic cell transplantation; HLA = human leukocyte antigen; haplo-related = haploidentical related donor; HCT-CI = Hematopoietic Cell Transplantation-Comorbidity Index; KPS = Karnofsky Performance Score; AML = acute myeloid leukemia; ALL = acute lymphoid leukemia; CML = chronic myeloid leukemia; MDS = myelodysplastic syndrome; MPN = myeloproliferative neoplasm; CLL = chronic lymphocytic leukemia; PCD = plasma cell disorders; PB = peripheral blood stem cell graft, BM = bone marrow graft; ptCy = posttransplant cyclophosphamide; CNI = calcineurin inhibitor; MMF= mycophenolate mofetil; MTX = methotrexate.