Risk factors associated with acute and chronic GVHD
| Conditioning regimen . | Hazard ratio (95% CI) . | P . |
|---|---|---|
| Grade II-IV acute GVHD* | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.79 (0.66-0.94) | .01 |
| Flu/Bu4/ATG | 0.61 (0.48-0.76) | <.001 |
| Flu/Bu2 | 0.55 (0.44-0.67) | <.001 |
| Flu/Bu2/ATG | 0.58 (0.46-0.73) | <.001 |
| Flu/Mel | 0.69 (0.54-0.89) | .004 |
| Flu/Mel/ATG | 0.86 (0.60-1.22) | .39 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.79 (0.61-1.03) | .08 |
| Flu/Bu2/ATG | 0.84 (0.63-1.11) | .22 |
| Flu/Mel/ATG | 1.24 (0.83-1.83) | .29 |
| Grade III-IV acute GVHD† | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.83 (0.63-1.11) | .21 |
| Flu/Bu4/ATG | 0.52 (0.46-0.75) | .001 |
| Flu/Bu2 | 0.62 (0.45-0.84) | .003 |
| Flu/Bu2/ATG | 0.48 (0.32-0.71) | <.001 |
| Flu/Mel | 0.77 (0.53-1.13) | .18 |
| Flu/Mel/ATG | 0.89 (0.53-1.50) | .67 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.79 (0.53-1.19) | .27 |
| Flu/Bu2/ATG | 0.62 (0.39-0.98) | .04 |
| Flu/Mel/ATG | 1.15 (0.65-2.05) | .62 |
| Chronic GVHD‡ | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.98 (0.83-1.15) | .80 |
| Flu/Bu4/ATG | 0.49 (0.39-0.61) | <.001 |
| Flu/Bu2 | 0.65 (0.54-0.78) | <.001 |
| Flu/Bu2/ATG | 0.53 (0.43-0.66) | <.001 |
| Flu/Mel | 0.81 (0.65-1.01) | .055 |
| Flu/Mel/ATG | 0.39 (0.25-0.61) | <.001 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.80 (0.63-1.01) | .065 |
| Flu/Bu2/ATG | 0.66 (0.50-0.86) | .003 |
| Flu/Mel/ATG | 0.48 (0.30-0.77) | .003 |
| Conditioning regimen . | Hazard ratio (95% CI) . | P . |
|---|---|---|
| Grade II-IV acute GVHD* | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.79 (0.66-0.94) | .01 |
| Flu/Bu4/ATG | 0.61 (0.48-0.76) | <.001 |
| Flu/Bu2 | 0.55 (0.44-0.67) | <.001 |
| Flu/Bu2/ATG | 0.58 (0.46-0.73) | <.001 |
| Flu/Mel | 0.69 (0.54-0.89) | .004 |
| Flu/Mel/ATG | 0.86 (0.60-1.22) | .39 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.79 (0.61-1.03) | .08 |
| Flu/Bu2/ATG | 0.84 (0.63-1.11) | .22 |
| Flu/Mel/ATG | 1.24 (0.83-1.83) | .29 |
| Grade III-IV acute GVHD† | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.83 (0.63-1.11) | .21 |
| Flu/Bu4/ATG | 0.52 (0.46-0.75) | .001 |
| Flu/Bu2 | 0.62 (0.45-0.84) | .003 |
| Flu/Bu2/ATG | 0.48 (0.32-0.71) | <.001 |
| Flu/Mel | 0.77 (0.53-1.13) | .18 |
| Flu/Mel/ATG | 0.89 (0.53-1.50) | .67 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.79 (0.53-1.19) | .27 |
| Flu/Bu2/ATG | 0.62 (0.39-0.98) | .04 |
| Flu/Mel/ATG | 1.15 (0.65-2.05) | .62 |
| Chronic GVHD‡ | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.98 (0.83-1.15) | .80 |
| Flu/Bu4/ATG | 0.49 (0.39-0.61) | <.001 |
| Flu/Bu2 | 0.65 (0.54-0.78) | <.001 |
| Flu/Bu2/ATG | 0.53 (0.43-0.66) | <.001 |
| Flu/Mel | 0.81 (0.65-1.01) | .055 |
| Flu/Mel/ATG | 0.39 (0.25-0.61) | <.001 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.80 (0.63-1.01) | .065 |
| Flu/Bu2/ATG | 0.66 (0.50-0.86) | .003 |
| Flu/Mel/ATG | 0.48 (0.30-0.77) | .003 |
Risks were higher in patients with MDS (hazard ratio [HR], 1.30; 95% CI, 1.14-1.48; P < .0001), HLA-matched (HR, 1.64; 95% CI, 1.41-1.90; P < .0001), and 1 HLA locus–mismatched (HR, 2.01; 95% CI, 1.60-2.52; P < .0001) unrelated donor transplants, and transplantation of peripheral blood graft (HR, 1.27; 95% CI, 1.03-1.56; P = .024).
Risks were higher in patients with MDS (HR, 1.47; 95% CI, 1.21-1.80; P = .0002), HLA-matched (HR, 1.47; 95% CI, 1.17-1.86; P = .001) and 1 HLA locus–mismatched (HR, 2.09; 95% CI, 1.49-2.94; P < .0001) unrelated donor transplants, and calcineurin inhibitor with methotrexate GVHD prophylaxis (HR, 1.47; 95% CI, 1.16-1.85; P = .001).
Risks were higher in patients with MDS (HR, 1.14; 95% CI, 1.01-1.29; P = .028), HLA-matched (HR, 1.30; 95% CI, 1.14-1.48; P < .0001) and 1 HLA locus–mismatched (HR, 1.74; 95% CI, 1.40-2.16; P < .0001) unrelated donor transplants, and transplantation of peripheral blood graft (HR, 1.79; 95% CI, 1.46-2.20; P <.0001).