Table 5.
Impact of CKD at 1 year on survival and transplant outcomes among survivors at 1 year
| Mortality | RFS | GRFS | TRM* | Relapse | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Variable | HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value | HR (95% CI) | P-value |
| CKD at 1 year | 2.06 (1.04–4.07) | 0.04 | 1.41 (0.75–2.64) | 0.29 | 1.65 (1.04–2.61) | 0.03 | 2.05 (0.82–5.09) | 0.12 | 1.27 (0.55–2.93) | .57 |
| Age at transplant | 1.00 (0.98–1.02) | 0.97 | 1.00 (0.98–1.02) | 0.68 | 0.99 (0.97–1.00) | 0.04 | 0.98 (0.96–1.01) | 0.20 | ||
| Diabetes | 2.99 (1.41–6.35) | 0.004 | 2.53 (1.24–5.15) | 0.01 | 1.30 (0.75–2.28) | 0.35 | 3.70 (1.30–10.58) | 0.01 | 1.67 (0.65–4.31) | 0.29 |
| Conditioning regimen (MAC versus RIC) |
0.73 (0.33–1.61) | 0.43 | 0.87 (0.30–2.53) | 0.78 | ||||||
| GVHD prophylaxis (ATG-PTCy-CSA versus others) |
0.56 (0.31–1.06) | 0.08 | 0.61 (0.32–1.15) | 0.13 | 0.76 (0.52–1.11) | 0.16 | 0.23 (0.09–0.57) | 0.002 | 1.47 (0.60–3.61) | 0.40 |
| cGVHD (moderate/severe) |
0.45 (0.22–0.93) | 0.03 | 0.41 (0.21–0.81) | 0.009 | 0.27 (0.09–0.77) | 0.01 | ||||
In this model, patients who died within 1 year post-transplant were excluded from the analyses. Impact of CKD at 1 year and other variables of interest on long-term (>1 year) survival and transplant outcomes were analyzed using Cox proportional hazard models (OS, RFS and GRFS) and Fine and Gray's completing risk model (TRM and relapse). The date 1 year post-allogeneic HSCT served as the index date in this model.
*There were only 21 events for TRM, thus limiting the amount of variables it was possible to include in the analyses.
CKD = chronic kidney disease; RFS = relapse-free survival; GRFS = graft-versus-host disease-free/relapse-free survival; TRM = transplant-related mortality; HR = hazard ratio; MAC = myeloablative conditioning; RIC = reduced intensity conditioning regimen; GVHD = graft-versus-host-disease; cGVHD = chronic graft-versus-host disease; ATG-PTCy-CSA = anti-thymocyte globulin with post-transplant cyclophosphamide and cyclosporine.