Risk factor models for cGVHD: landmark analysis from HCT day 120+
| . | c GVHD . | Death without cGVHD . | ||||
|---|---|---|---|---|---|---|
| HR . | 95% CI . | P . | HR . | 95% CI . | P . | |
| Acute GVHD response∗ | ||||||
| No acute GVHD | 1.00 | 1.00 | ||||
| SS | 1.32 | (0.85-2.05) | .21 | 0.96 | (0.62-1.50) | .86 |
| SD | 2.17 | (1.46-3.23) | <.01 | 0.85 | (0.53-1.36) | .50 |
| Steroid refractory | 1.83 | (1.22-2.74) | <.01 | 1.47 | (1.00-2.15) | .05 |
| Male sex | 1.08 | (0.80-1.46) | .62 | 1.01 | (0.76-1.35) | .93 |
| Age† (50 vs 10 y) | 6.27 | (3.15-12.5) | <.01 | 1.54 | (0.91-2.63) | .26 |
| Donor type | ||||||
| Matched sibling | 1.00 | 1.00 | ||||
| Haploidentical | 0.23 | (0.07-0.74) | .01 | 2.73 | (1.60-4.65) | <.01 |
| Matched URD | 0.46 | (0.26-0.82) | <.01 | 1.78 | (1.02-3.10) | .04 |
| Mismatched URD | 0.57 | (0.14-2.35) | .43 | 2.66 | (0.63-11.4) | .18 |
| UCB | 0.34 | (0.24-0.48) | <.01 | 1.40 | (1.00-1.95) | .05 |
| DRI | ||||||
| Low risk | 1.00 | 1.00 | ||||
| Intermediate risk | 0.58 | (0.39-0.86) | <.01 | 2.20 | (1.22-3.97) | <.01 |
| High/very high risk | 0.43 | (0.24-0.77) | <.01 | 3.45 | (1.82-6.53) | <.01 |
| HCT comorbidity index | ||||||
| 0 | 1.00 | 1.00 | ||||
| 1-2 | 1.30 | (0.91-1.86) | .15 | 0.98 | (0.68-1.40) | .90 |
| ≥3 | 1.18 | (0.81-1.71) | .40 | 1.25 | (0.88-1.77) | .22 |
| RIC | 0.50 | (0.33-0.75) | <.01 | 1.55 | (1.00-2.42) | .05 |
| . | c GVHD . | Death without cGVHD . | ||||
|---|---|---|---|---|---|---|
| HR . | 95% CI . | P . | HR . | 95% CI . | P . | |
| Acute GVHD response∗ | ||||||
| No acute GVHD | 1.00 | 1.00 | ||||
| SS | 1.32 | (0.85-2.05) | .21 | 0.96 | (0.62-1.50) | .86 |
| SD | 2.17 | (1.46-3.23) | <.01 | 0.85 | (0.53-1.36) | .50 |
| Steroid refractory | 1.83 | (1.22-2.74) | <.01 | 1.47 | (1.00-2.15) | .05 |
| Male sex | 1.08 | (0.80-1.46) | .62 | 1.01 | (0.76-1.35) | .93 |
| Age† (50 vs 10 y) | 6.27 | (3.15-12.5) | <.01 | 1.54 | (0.91-2.63) | .26 |
| Donor type | ||||||
| Matched sibling | 1.00 | 1.00 | ||||
| Haploidentical | 0.23 | (0.07-0.74) | .01 | 2.73 | (1.60-4.65) | <.01 |
| Matched URD | 0.46 | (0.26-0.82) | <.01 | 1.78 | (1.02-3.10) | .04 |
| Mismatched URD | 0.57 | (0.14-2.35) | .43 | 2.66 | (0.63-11.4) | .18 |
| UCB | 0.34 | (0.24-0.48) | <.01 | 1.40 | (1.00-1.95) | .05 |
| DRI | ||||||
| Low risk | 1.00 | 1.00 | ||||
| Intermediate risk | 0.58 | (0.39-0.86) | <.01 | 2.20 | (1.22-3.97) | <.01 |
| High/very high risk | 0.43 | (0.24-0.77) | <.01 | 3.45 | (1.82-6.53) | <.01 |
| HCT comorbidity index | ||||||
| 0 | 1.00 | 1.00 | ||||
| 1-2 | 1.30 | (0.91-1.86) | .15 | 0.98 | (0.68-1.40) | .90 |
| ≥3 | 1.18 | (0.81-1.71) | .40 | 1.25 | (0.88-1.77) | .22 |
| RIC | 0.50 | (0.33-0.75) | <.01 | 1.55 | (1.00-2.42) | .05 |
Other pairwise comparisons for cGVHD: SR vs SD; HR, 0.84 (95% CI, 0.54-1.31; P = .44); SS vs SD; HR, 0.61 (95% CI, 0.38-0.98; P = .04).
Age was modeled as a continuous variable using a 3-knot restricted cubic spline to model nonlinear effects. Risk of cGVHD increased proportionally with age for ages <∼50 years but was similar for ages >50 years. The reference ages of 50 and 10 years were chosen to show the total magnitude of this effect.15