Risk factors associated with NRM, relapse, treatment failure, and overall mortality
| Conditioning regimen . | Hazard ratio (95% CI) . | P . |
|---|---|---|
| NRM* | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.99 (0.75-1.29) | .92 |
| Flu/Bu4/ATG | 0.95 (0.69-1.32) | .77 |
| Flu/Bu2 | 0.71 (0.52-0.98) | .03 |
| Flu/Bu2/ATG | 0.72 (0.50-1.02) | .07 |
| Flu/Mel | 1.12 (0.80-1.57) | .49 |
| Flu/Mel/ATG | 1.17 (0.74-1.84) | .50 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.63 (0.45-0.88) | .008 |
| Flu/Bu2/ATG | 0.64 (0.43-0.94) | .02 |
| Flu/Mel/ATG | 1.04 (0.65-1.67) | .87 |
| Relapse† | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 1.05 (1.07-1.81) | .64 |
| Flu/Bu4/ATG | 1.47 (1.14-1.88) | .003 |
| Flu/Bu2 | 1.66 (1.34-2.07) | <.0001 |
| Flu/Bu2/ATG | 2.09 (1.65-2.64) | <.0001 |
| Flu/Mel | 0.71 (0.50-1.00) | .05 |
| Flu/Mel/ATG | 0.99 (0.59-1.64) | .96 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 2.32 (1.67-3.33) | <.0001 |
| Flu/Bu2/ATG | 2.95 (2.07-4.19) | <.0001 |
| Flu/Mel/ATG | 1.39 (0.79-2.47) | .26 |
| Treatment failure‡ | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 1.03 (0.86-1.22) | .75 |
| Flu/Bu4/ATG | 1.22 (1.00-1.47) | .05 |
| Flu/Bu2 | 1.24 (1.03-1.49) | .02 |
| Flu/Bu2/ATG | 1.41 (1.16-1.72) | .0006 |
| Flu/Mel | 0.93 (0.73-1.17) | .53 |
| Flu/Mel/ATG | 1.16 (0.84-1.61) | .37 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 1.33 (1.06-1.69) | .01 |
| Flu/Bu2/ATG | 1.52 (1.20-1.94) | .0006 |
| Flu/Mel/ATG | 1.25 (0.85-1.79) | .22 |
| Overall mortality§ | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 1.05 (0.88-1.27) | .54 |
| Flu/Bu4/ATG | 1.26 (1.03-1.56) | .02 |
| Flu/Bu2 | 1.14 (0.93-1.38) | .20 |
| Flu/Bu2/ATG | 1.28 (1.04-1.58) | .02 |
| Flu/Mel | 0.92 (0.72-1.18) | .50 |
| Flu/Mel/ATG | 1.36 (0.98-1.91) | .07 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 1.23 (0.97-1.56) | .08 |
| Flu/Bu2/ATG | 1.40 (1.08-1.80) | .009 |
| Flu/Mel/ATG | 1.49 (1.03-2.14) | .03 |
| Conditioning regimen . | Hazard ratio (95% CI) . | P . |
|---|---|---|
| NRM* | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 0.99 (0.75-1.29) | .92 |
| Flu/Bu4/ATG | 0.95 (0.69-1.32) | .77 |
| Flu/Bu2 | 0.71 (0.52-0.98) | .03 |
| Flu/Bu2/ATG | 0.72 (0.50-1.02) | .07 |
| Flu/Mel | 1.12 (0.80-1.57) | .49 |
| Flu/Mel/ATG | 1.17 (0.74-1.84) | .50 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 0.63 (0.45-0.88) | .008 |
| Flu/Bu2/ATG | 0.64 (0.43-0.94) | .02 |
| Flu/Mel/ATG | 1.04 (0.65-1.67) | .87 |
| Relapse† | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 1.05 (1.07-1.81) | .64 |
| Flu/Bu4/ATG | 1.47 (1.14-1.88) | .003 |
| Flu/Bu2 | 1.66 (1.34-2.07) | <.0001 |
| Flu/Bu2/ATG | 2.09 (1.65-2.64) | <.0001 |
| Flu/Mel | 0.71 (0.50-1.00) | .05 |
| Flu/Mel/ATG | 0.99 (0.59-1.64) | .96 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 2.32 (1.67-3.33) | <.0001 |
| Flu/Bu2/ATG | 2.95 (2.07-4.19) | <.0001 |
| Flu/Mel/ATG | 1.39 (0.79-2.47) | .26 |
| Treatment failure‡ | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 1.03 (0.86-1.22) | .75 |
| Flu/Bu4/ATG | 1.22 (1.00-1.47) | .05 |
| Flu/Bu2 | 1.24 (1.03-1.49) | .02 |
| Flu/Bu2/ATG | 1.41 (1.16-1.72) | .0006 |
| Flu/Mel | 0.93 (0.73-1.17) | .53 |
| Flu/Mel/ATG | 1.16 (0.84-1.61) | .37 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 1.33 (1.06-1.69) | .01 |
| Flu/Bu2/ATG | 1.52 (1.20-1.94) | .0006 |
| Flu/Mel/ATG | 1.25 (0.85-1.79) | .22 |
| Overall mortality§ | ||
| Risks compared with Bu4/Cy | ||
| Bu4/Cy | 1.00 | |
| Flu/Bu4 | 1.05 (0.88-1.27) | .54 |
| Flu/Bu4/ATG | 1.26 (1.03-1.56) | .02 |
| Flu/Bu2 | 1.14 (0.93-1.38) | .20 |
| Flu/Bu2/ATG | 1.28 (1.04-1.58) | .02 |
| Flu/Mel | 0.92 (0.72-1.18) | .50 |
| Flu/Mel/ATG | 1.36 (0.98-1.91) | .07 |
| Risks compared with Flu/Mel | ||
| Flu/Mel | 1.00 | |
| Flu/Bu2 | 1.23 (0.97-1.56) | .08 |
| Flu/Bu2/ATG | 1.40 (1.08-1.80) | .009 |
| Flu/Mel/ATG | 1.49 (1.03-2.14) | .03 |
Other significant factors in multivariate models are listed below.
Risks were higher in patients aged 45-65 years (hazard ratio [HR], 1.61; 95% CI, 1.19-2.16; P = .002) and 65-83 years (HR, 2.30; 95% CI, 1.62-3.28; P < .0001) compared with those aged 18-44 years, males (HR, 1.29; 95% CI, 1.07-1.56; P = .006), diagnosis of MDS (HR, 1.42; 95% CI, 1.17- 1.71; P = .0003), performance score ≤ 80 (HR, 1.29; 95% CI, 1.08-1.55; P = .006), HCT-CI score ≥ 3 (HR, 1.36; 95% CI, 1.14-1.63; P = .0008), and HLA-matched unrelated (HR, 1.24; 95% CI, 1.01-1.53; P = .045) and 1 HLA locus–mismatched unrelated (HR, 1.78; 95% CI, 1.32-2.38; P = .0001) donor transplants compared with HLA-matched sibling transplants.
Risks were higher in patients with performance score ≤ 80 (HR, 1.20; 95% CI, 1.04-1.39; P = .013), HCT-CI score ≥ 3 (HR, 1.23; 95% CI, 1.06-1.41; P = .005), AML (HR, 1.59; 95% CI, 1.29-1.96; P < .0001), and intermediate disease risk (HR, 1.62; 95% CI, 1.08-2.44; P = .019) and high disease risk (HR, 2.84; 95% CI, 1.82-4.43; P < .0001) compared with low disease risk index. Risks were lower after HLA-matched (HR, 0.77; 95% CI, 0.66-0.90; P = .001) and 1 HLA locus–mismatched unrelated (HR, 0.65; 95% CI, 0.49-0.86; P = .003) donor transplants compared with HLA-matched sibling transplants.
Risks were higher in patients aged 45-64 years (HR, 1.30; 95% CI, 1.10-1.55; P = .0025) and ≥65 years (HR, 1.44; 95% CI, 1.16-1.77; P = 0.0007) compared with 18-44 years, with AML (HR, 1.20; 95% CI, 1.02-1.43; P = .03), performance score ≤ 80 (HR, 1.23; 95% CI, 1.10-1.38; P = .0003), HCT-CI score ≥ 3 (HR, 1.27; 95% CI, 1.14-1.42; P < .0001), and intermediate (HR, 1.49; 95% CI, 1.07-2.06; P = .02) and high (HR, 2.20; 95% CI, 1.54-3.15; P < .0001) disease risk index compared with low disease risk index.
Risks were higher in patients aged 45-64 years (HR, 1.40; 95% CI, 1.16-1.68; P = .0004) and ≥65 years (HR, 1.60; 95% CI, 1.28-1.99; P < .0001) compared with 18-44 years, performance score ≤ 80 (HR, 1.27; 95% CI, 1.13-1.44; P < .0001) and HCT-CI score ≥ 3 (HR, 1.33; 95% CI, 1.18-1.50; P < .0001), and intermediate (HR, 1.74; 95% CI, 1.20-2.51; P = .003) and high (HR, 2.24; 95% CI, 1.54-3.26; P < .0001) disease risk index compared with low disease risk index.