학술논문
Post-transplant cyclophosphamide for GVHD prophylaxis compared to ATG-based prophylaxis in unrelated donor transplantation.
Document Type
Article
Author
Bailén, Rebeca; Kwon, Mi; Pascual-Cascón, María Jesús; Ferrà, Christelle; Sanz, Jaime; Gallardo-Morillo, Anabel; García-Sola, Abel; Torrent, Anna; Jiménez-Lorenzo, María José; Piñana, José Luis; Montoro, Juan; Oarbeascoa, Gillen; Dorado, Nieves; Gómez-Centurión, Ignacio; Muñoz, Cristina; Martínez-Laperche, Carolina; Anguita, Javier; Buño, Ismael; Díez-Martín, José Luis
Source
Subject
*CYCLOPHOSPHAMIDE
*PREVENTIVE medicine
*GRAFT versus host disease
*HEMATOPOIETIC stem cell transplantation
*BLOOD cells
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Language
ISSN
0939-5555
Abstract
Post-transplant cyclophosphamide (PTCY) effectively prevents graft-versus-host disease after unmanipulated HLA-haploidentical HSCT. The use of PTCY in the unrelated donor HSCT setting is less explored. We conducted a retrospective study of 132 consecutive patients undergoing a matched or 9/10 mismatched unrelated donor HSCT in 4 centers in Spain, 60 with anti-thymocyte globulin (ATG)-based prophylaxis combined with MTX-CsA, and 72 using a PTCY-based regimen. Peripheral blood stem cells were used as graft in most patients (111 patients, 84%); mMUD donors were balanced between groups. Cumulative incidences of grades II–IV and III–IV acute GVHD at 100 days were lower in the PTCy group (46% vs. 67%, p = 0.008; 3% vs. 34%, p = 0.003), without statistically significant differences in the 2-year cumulative incidence of chronic moderate-severe GVHD. At 2 years, no significant differences were observed in overall survival, event-free survival, cumulative incidence of relapse, and non-relapse mortality. GVHD was the most frequent cause of NRM in the ATG group. No differences were observed between groups in the composite endpoint of GVHD-free and relapse-free survival. In this study, PTCy combined with additional immunosuppression after MUD/mMUD HSCT showed a reduction of aGVHD rate with safety results comparable to those obtained with the ATG-based prophylaxis. [ABSTRACT FROM AUTHOR]