Table 2.

Multivariable hazard of relapse in AYA and children

Relapse during therapya (all patients: n = 184)Relapse after completion of therapya (patients completed therapy: n = 119)
HR (95% CI)PHR (95% CI)P
Age group
Child1.0 (—)1.0 (—)
 AYA10.5 (2.1–52.5)0.0047.7 (2.5–23.9)<0.001
Duration of therapy
Duration of maintenanceb1.0 (0.8–1.3)0.90.9 (0.8–0.9)<0.001
Duration of consolidationb1.0 (0.8–1.3)0.90.9 (0.8–1.0)0.2
Oncology service and therapy types
Pediatric oncology + pediatric therapy1.0 (—)1.0 (—)
 Adult oncology + adult therapy2.5 (1.1–5.7)0.030.6 (0.2–1.8)0.3
 Mixed oncology + mixed therapy0.5 (0.2–1.8)0.30.23 (0.04–1.0)0.04
Insurance and SES
Private insurance + high SES1.0 (—)1.0 (—)
 Public insurance + low SES0.7 (0.3–1.5)0.36.2 (1.8–21.9)0.004
Mixed profile0.9 (0.4–0.8)0.72.1 (0.5–8.3)0.3
Race/ethnicity
Non-Hispanic white1.0 (—)1.0 (—)
 Nonwhite race/ethnicity2.1 (1.1–4.0)0.030.6 (0.2–1.5)0.2
Clinical trial enrollment
Enrolled on clinical trial1.0 (—)1.0 (—)
 Not enrolled on clinical trial1.8 (0.9–3.5)0.090.6 (0.3–1.5)0.3
Gender
Female1.0 (—)1.0 (—)
 Male0.7 (0.4–1.3)0.33.3 (1.3–8.5)0.01
Time
Time in monthsb1.0 (0.8–1.3)0.81.0 (0.9–1.0)<0.001
Clinical prognosticators
WBC at diagnosis <50K1.0 (—)1.0 (—)
 WBC at diagnosis >50K1.6 (1.0–3.0)0.073.5 (1.4–8.8)0.007
Precursor B-cell1.0 (—)1.0 (—)
 T-cell1.1 (0.6–2.1)0.80.2 (0.07–0.7)0.007
No high-risk cytogenetics identified1.0 (—)1.0 (—)
 High-risk cytogenetic profile1.1 (0.5–2.3)0.80.5 (0.1–2.0)0.3
 M1 marrow at end of inductionc1.0 (—)1.0 (—)
 M2-M3 marrow at end of inductionc1.8 (0.9–4.0)0.12.0 (0.5–7.5)0.3
 CNS negative1.0 (—)
 CNS positive4.9 (1.6–15.3)0.006
  • aAdjusted discrete time survival analysis, modeling hazard of relapse with death due to nonrelapse causes and date of last contact as censoring events. Bolded values represent statistically significant findings. On-therapy model adjusted for AYA*time interaction.

  • bThese variables were modeled as time-varying covariates. Months represents: (i) months from remission in the model calculating hazard of relapse on therapy; (ii) months from completion of therapy in the model calculating hazard of relapse after completing therapy. HRs represent each additional month of time from remission/completion of therapy, or each additional month of therapy.

  • cPatients with M2-M3 marrows (≥5% blasts) at the end of induction were compared with patients who either (i) had M1 marrows (<5% blasts) at the end of induction or (ii) did not have a documented end of induction marrow, but the first marrow documented after initiation of treatment (>36 days) was M1.