Page 308 - Haematologica Vol. 109 - July 2024

LETTER TO THE EDITOR
There were no significant predictors of grade III-IV acute GvHD in any disease type.
Next, we tested whether the use of PTCy prophylaxis altered these observations. We used a separate CIBMTR matched unrelated donor peripheral blood HCT cohort5 of patients with AML (n=136), ALL (n=42) or MDS (n=64) who received PTCy/CNI/MMF prophylaxis (Online Supple- mentary Table S2). In this population too, in multivariate analysis, CMV+ recipients had a significantly worse OS
Table 1. Baseline characteristics.
than CMV– recipients, but only if they had AML (hazard ratio [HR]=2.7, 95% CI: 1.1-6.4; P=0.03) and not if they had ALL (HR=0.4, 95% CI: 0.1-1.5; P=0.2), or MDS (HR=0.7, 95% CI: 0.3-1.5; P=0.3). The risk of relapse and NRM did not differ by CMV serostatus in any disease group, al- though these analyses were limited by the small number of events.
In summary, in the CNI study population of patients who all received tacrolimus for GvHD prophylaxis with either
N of patients
MTX/CMV+ MTX/CMV– MMF/CMV+ MMF/CMV–
1,527 916 395 267
Recipient age in years
Median (range) 57 (18-78) 56 (19-78) 62 (20-83) 61 (19-78)
≤40, N (%) 278 (18) 168 (18) 34 (9) 34 (13)
41-50, N (%) 231 (15) 142 (15) 38 (10) 32 (12)
51-60, N (%) 382 (25) 250 (27) 87 (22) 56 (21)
>60, N (%) 636 (42) 356 (39) 236 (60) 145 (54)
Disease, N (%)
AML 836 (55) 391 (43) 223 (56) 122 (46)
ALL 239 (16) 135 (15) 44 (11) 35 (13)
MDS 452 (30) 390 (43) 128 (32) 110 (41)
Conditioning intensity, N (%)
MAC 889 (58) 506 (55) 104 (26) 93 (35)
RIC/NMA 631 (41) 408 (44) 290 (73) 174 (65)
Missing 7 2 1 0
In vivo T-cell depletion, N (%)
Yes 624 (41) 594 (65) 190 (48) 140 (52)
No 903 (59) 322 (35) 205 (52) 127 (48)
Donor/recipient gender, N (%)
Male/male 652 (43) 443 (48) 170 (43) 134 (50)
Male/female 489 (32) 227 (25) 105 (27) 59 (22)
Female/male 155 (10) 123 (13) 55 (14) 36 (13)
Female/female 230 (15) 123 (13) 65 (16) 38 (14)
Missing 1 0 0 0
Disease status at HCT, N (%)
Early 753 (49) 395 (43) 170 (43) 106 (40)
Intermediate 193 (13) 114 (12) 54 (14) 27 (10)
Advanced 563 (37) 397 (43) 164 (41) 132 (49)
Missing 18 (1) 10 (1) 7 (2) 2 (1)
HCT-CI, N (%)
0-2 734 (48) 497 (54) 164 (41) 121 (45)
≥3 793 (52) 419 (46) 231 (58) 146 (55)
Donor age, N (%)
>35 years 408 (27) 216 (24) 96 (24) 51 (19)
Donor CMV, N (%)
Seronegative 884 (58) 681 (74) 214 (54) 204 (76)
Seropositive 643 (42) 235 (26) 181 (46) 63 (24)
Year of HCT, median (range) 2014 (2008-17) 2014 (2008-17) 2013 (2008-17) 2014 (2008-17)
Follow-up among survivors, in months, median (IQR)
48 (36-65) 48 (36-68) 50 (36-73) 49 (36-72)
MTX: methotrexate; CMV: cytomegalovirus; MMF: mycophenolate mofetil; AML: acute myeloid leukemia; ALL: acute lymphoblastic leukemia; MDS: myelodysplastic neoplasms; MAC: myeloablative conditioning; RIC: reduced-intensity conditioning; NMA: non-myeloablative condition- ing; HCT: hematopoietic cell transplantation; HCT-CI: Hematopoietic Cell Transplantation-specific Comorbidity Index; IQR: interquartile range.
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