Factors influencing survival after allogeneic stem cell transplantation for hematologic malignancies in adult patients: A retrospective cohort study

 Iveta Oravcova, Zuzana Rusinakova, Silvia Cingelova, Miriam Ladicka, Eva Mikuskova, Andrej Vranovsky, Ludmila Demitrovicova, Barbora Kasperova, Lucia Petrikova, Alica Slobodova, Radka Vasickova, Lubos Drgona

Abstract:

Allogeneic stem cell transplantation (alloSCT) remains the established main treatment option with curative potential for many hematologic malignancies. We conducted a retrospective analysis of 104 adult patients who underwent alloSCT between March 2013 and November 2023. Kaplan-Meier survival analysis, the chi-square test, and Cox regression models were used to identify risk factors and outcomes. The median follow-up of the cohort was 19 (0.3–128.1) months. The median age of the recipients was 49 (19–65) years, and 57 (54.8%) recipients were males. Ninety (86.5%) patients had a matched sibling, and 14 (13.5%) had a haploidentical donor. According to the multivariable analysis, a body mass index (BMI) ≥30 kg/m2 (p=0.02) and status without chronic graft-versus-host disease (cGVHD) (p=0.04) were significantly associated with worse overall survival (OS). A BMI ≥30 kg/m2 was also predictive of worse relapse-free survival (p=0.01). The cumulative incidence rates of nonrelapse mortality (NRM) and relapse mortality (RM) at 1 year were 8.5% (95% CI: 4.3–16.5%) and 26.7% (95% CI: 19.1–37.4%), respectively. Patients without cGVHD had significantly higher RM than patients with cGVHD (p<0.001), whereas patients with cGVHD had significantly higher NRM (p=0.01). Patients with a BMI ≥30 kg/m2 had significantly more posttransplant fatal events (p<0.001). Our analysis revealed that a BMI ≥30 kg/m2 and a status without cGVHD were significantly associated with worse OS. NRM was higher in patients with cGVHD, whereas patients without cGVHD died mostly from relapses.