TABLE 2.
Clinical outcomes after transplant in 105 patients with refractory or relapsed acute myeloid leukemia
| Characteristic | Total cases | Group A (no DLI) | Group B (DLI) | Type of donor | |||
|---|---|---|---|---|---|---|---|
| HLA‐matched | Haploidentical | P value † | |||||
| Case number | 105 | 18 | 87 | 42 | 63 | ||
| Onset time of Acute GvHD (day, median [range]) | 46.0 (19.0‐100.0) | 34.0 (19.0‐42.0) | 72.5 (42.0‐100.0) | 56.0 (19.0‐75.0) | 44.5 (19.0‐100.0) | 0.905 | |
| Severity of Acute GvHD (n) | |||||||
| Grade 1 | 8 | 0 | 8 | 3 | 5 | ||
| Grade 2 | 30 | 5 | 25 | 8 | 22 | ||
| Grade 3 | 6 | 3 | 3 | 2 | 4 | ||
| Grade 4 | 5 | 3 | 2 | 2 | 3 | ||
| Cumulative incidence of acute GvHD (%, [95% CI]) | |||||||
| Grade 1‐4 | 46.7 (36.9‐56.5) | 61.1 (46.4‐75.8) | 43.7 (33.3‐54.1) | 35.7 (25.3‐46.1) | 54.0 (41.5‐66.5) | 0.071 | |
| Grade 2‐4 | 40.6 (30.6‐50.6) | 61.1 (46.4‐75.8) | 36.5 (26.1‐46.9) | 29.7 (19.3‐40.1) | 48.5 (35.4‐61.6) | 0.066 | |
| Grade 3‐4 | 12.2 (5.1‐19.3) | 34.3 (19.6‐49.0) | 7.5 (1.0‐14.0) | 11.2 (1.7‐20.7) | 14.0 (5.6‐22.4) | 0.628 | |
| Onset time of chronic GvHD (day, median [range]) | 138.0 (100.0‐200.0) | 114.5 (110.0‐150.0) | 140.0 (100.0‐200.0) | 145.0 (100.0‐200.0) | 130.0 (109.0‐200.0) | 0.322 | |
| Severity of chronic GvHD (n) | |||||||
| Mild | 31 | 2 | 29 | 12 | 19 | ||
| Moderate | 38 | 4 | 34 | 14 | 24 | ||
| Severe | 8 | 0 | 8 | 4 | 4 | ||
| Cumulative incidence of chronic GvHD (%, [95% CI]) | |||||||
| ≥ mild | 73.3 (67.4‐79.2) | 33.3 (17.4‐49.2) | 81.6 (75.7‐87.5) | 71.4 (61.4‐81.4) | 74.6 (67.3‐81.9) | 0.510 | |
| ≥ moderate | 60.1 (51.1‐69.1) | 26.2 (10.3‐42.1) | 67.2 (55.8‐78.6) | 56.8 (43.7‐69.9) | 62.4 (53.8‐71.0) | 0.571 | |
| ≥ severe | 19.5 (8.3‐30.7) | 0.0 (0.0‐0.0) | 23.0 (9.9‐36.1) | 15.6 (3.8‐27.4) | 24.1 (16.8‐31.4) | 0.469 | |
| CIR at 5 years (%, [95% CI]) | 31.5 (21.9‐41.1) | 50.0 (34.1‐65.9) | 27.6 (17.6‐37.6) | 35.7 (23.4‐48.0) | 28.5 (18.5‐38.5) | 0.448 | |
| Onset time of relapse (day, median [range]) | 128.0 (34.0‐1173.0) | 68.0 (34.0‐480.0) | 147.0 (60.0‐1173.0) | 120.0 (50.0‐1173.0) | 130.5 (34.0‐624.0) | 0.929 | |
| TRM at 5 years (%, [95% CI]) | 22.1 (11.3‐32.9) | 33.3 (16.6‐50.0) | 21.6 (11.2‐32.0) | 28.9 (16.2‐30.6) | 19.7 (10.9‐28.5) | 0.285 | |
| Onset time of TRM (day, median [range]) | 280.0 (60.0‐1963.0) | 88.0 (60.0‐176.0) | 329.0 (108.0‐1963.0) | 329.0 (88.0‐1353.0) | 220.0 (60.0‐1963.0) | 0.413 | |
| LFS at 5 years (%, [95% CI]) | 46.4 (36.8‐56.0) | 16.7 (3.4‐30.0) | 50.8 (40.0‐61.6) | 35.4 (20.9‐49.9) | 51.7 (43.1‐60.3) | 0.148 | |
| Median LFS (months, median [95% CI]) | 51.5 (4.6‐82.6) | 3.5 (1.1‐5.9) | 69.2 (6.2‐84.3) | 41.4 (3.8‐78.7) | 60.8 (6.0‐86.5) | 0.148 | |
| Survival at 5 years (%, [95% CI]) | 46.4 (36.8‐56.0) | 16.7 (3.4‐30.0) | 50.8 (40.0‐61.6) | 35.4 (20.9‐49.9) | 51.7 (43.1‐60.3) | 0.132 | |
| Median survival (months, median [95% CI]) | 52.2 (4.6‐83.2) | 4.7 (3.3‐6.1) | 70.0 (6.5‐91.9) | 43.2 (4.1‐79.6) | 60.8 (6.7‐86.5) | 0.132 | |
| Cause of mortality (n) | |||||||
| Relapse | 32 | 9 | 23 | 15 | 17 | ||
| Infection | 19 | 4 | 15 | 10 | 9 | ||
| Grade 4 acute GvHD | 3 | 2 | 1 | 1 | 2 | ||
| Severe chronic GvHD (lung) | 3 | 0 | 3 | 0 | 3 | ||
†
P value represents comparison between patients receiving HLA‐matched HSCT and patients receiving haploidentical HSCT.
Abbreviations: DLI, donor lymphocyte infusion; HLA, human leucocyte antigen; GvHD, graft‐versus‐host disease; CIR, cumulative incidence of relapse; TRM, treatment‐related mortality; LFS, leukemia‐free survival.