Several differences exist which could explain the differences between our analysis and the CIBMTR study. compared with Bu/Flu. Multivariable analysis did not reveal any difference in outcomes between KDELC1 antibody both regimens. In summary, thymoglobulin at 4.5 mg/kg did not have any adverse impact on survival when used with RIC regimen. Both Bu/Flu/TBI and Bu/Flu conditioning regimens yielded comparable survival. value of 0.05 among 12 patient baseline characteristics (age at transplant, sex, disease status at transplant, HCT-CI, cytogenetics at diagnosis, ABO matching, CMV serotype, sex mismatch, HLA match, Karnofsky Overall performance Score, CD34, and total nucleated cells) for all those multivariable analyses to assess associations between group and outcomes. Based on univariable analysis, two covariates (age at transplant and comorbidity index) were selected for aGVHD and one covariate (disease status at transplant) for NRM and RFS. No covariate was selected for other outcomes (i.e., cGVHD, relapse, GRFS, and OS). In particular, multivariable analyses for cGVHD included Taranabant aGVHD as an additional covariate; for relapse, NRM and RFS included aGVHD and considerable cGVHD as additional covariates, and Taranabant for OS included aGVHD, considerable cGVHD, and relapse as additional covariates. The proportional hazard assumption was checked, and no violation was found except for aGVHD, cGVHD, and relapse, which were resolved using time-varying covariates. The follow-up time was calculated using the reverse Kaplan-Meier estimate. Results Patient characteristics From January 2005 through December 2017, 122 patients with AML underwent URD PBSCT. Of these, 88 (72%) patients experienced de novo and 34 (28%) experienced secondary AML (Table 1). Sixty-four patients (52%) received Bu/Flu/TBI as a RIC regimen, and 58 (48%) received Bu/Flu as a MAC regimen. Patients in Bu/Flu/TBI were older (66 vs Taranabant 53 years, 0.001), had worse Karnofsky overall performance status (70% vs 80%, = 0.03), a higher proportion had intermediate risk AML (72% vs 43%, = 0.001), and a higher proportion received 8/8 HLA matched URD (88% vs 64%, = 0.004) compared to Bu/Flu. Table 1 Patient characteristics = 64)= 58)= 122)= 0.05), while platelet engraftment time was 15 (range, 0C33) days for both groups (= 0.38). One individual in the Bu/Flu group experienced primary graft failure. Median length of hospitalization was 25 (range, 19C46) and 27 (range, 20C90) days for Bu/Flu/TBI and Bu/Flu, respectively (= 0.05). Donor chimerism was evaluated around day + 30 post-transplant. Median donor cell percentage was 100% for both myeloid and lymphoid lineage in both groups. Acute and chronic GVHD Six-month cumulative incidence of grades IICIV aGVHD was 26.6% (95% CI, 16.4C37.9%) and 55.6% (95% CI, 41.6C67.5%) for Bu/Flu/TBI and Bu/Flu, respectively (= 0.002). Cumulative incidence of grades IIICIV aGVHD at 6 months is usually 6.2% (95% CI, 2C14%) and 26.1% (95% CI, 15.5C38%) for Bu/Flu/TBI and Bu/Flu, respectively (= 0.009) (Fig. 1a). One-year cumulative incidence of cGVHD is usually 41.2% (95% CI, 28.8C53.1%) and 44.8% (95% CI, 31.6C57.2%) for Bu/Flu/TBI and Bu/Flu, respectively (= 0.75) (Fig. 1b). After adjusting for age at transplant and HCT-CI, multivariable analysis did not demonstrate any significant difference in aGVHD between Bu/Flu/TBI and Bu/Flu groups (HR = 1.71, = 0.10). Similarly, no difference in cGVHD is usually noted between the two groups (HR = 0.83, = 0.51) in multivariable analysis (Table 2). Acute GVHD is usually associated with a high risk of cGVHD (HR = 2.73, = 0.002) (Table S1). Open in a separate windows Fig. 1 a Cumulative incidence curves for grades IIICIV acute GVHD (aGVHD IIICIV) with disease relapse or death as competing risks by conditioning regimen. b Cumulative incidence curves for chronic GVHD (cGVHD) with disease relapse or death as competing risks by conditioning regimen Table 2 Multivariable analyses of acute GVHD, chronic GVHD, non-relapse mortality (NRM), relapse, relapse-free survival (RFS), GVHD-free/relapse-free survival (GRFS), and overall survival (OS) by group (BU-FLU vs. BU-FLU-TBI) 0.99). Two patients (3%) in Bu/Flu/TBI and six patients (10%) in Bu/Flu developed GI CMV disease (= 0.12). Rate of EBV reactivation was 8% and 7% in Bu/Flu/TBI and Bu/Flu, respectively ( 0.99). For Bu/Flu/TBI and Bu/Flu, occurred in 25% and 22% of patients, respectively (= 0.83); systemic bacterial infections occurred in 22% and 21% of patients, respectively ( 0.99); was noted in 2% and 7%, respectively (= 0.19); and mucormycosis was observed in 2% patients in Bu/Flu. NRM One-year cumulative incidence of NRM is usually 17.4% (95% CI, 9.2C27.8%) for Bu/Flu/TBI and 29.3% (95% CI, 18.2C41.4%) for.