학술논문
Graft-versus-host-disease prophylaxis with ATG or PTCY in patients with lymphoproliferative disorders undergoing reduced intensity conditioning regimen HCT from one antigen mismatched unrelated donor
Document Type
Original Paper
Author
Paviglianiti, Annalisa; Ngoya, Maud; Peña, Marta; Boumendil, Ariane; Gülbas, Zafer; Ciceri, Fabio; Bonifazi, Francesca; Russo, Domenico; Fegueux, Nathalie; Stolzel, Friedrich; Bulabois, Claude Eric; Socié, Gerard; Forcade, Edouard; Solano, Carlo; Finel, Hervé; Robinson, Stephen; Glass, Bertram; Montoto, Silvia
Source
Bone Marrow Transplantation: Official journal of the European Society for Blood and Marrow Transplantation. 59(5):597-603
Subject
Language
English
ISSN
0268-3369
1476-5365
1476-5365
Abstract
Post-transplant cyclophosphamide (PTCY) has been introduced as graft-versus-host disease (GvHD) prophylaxis in mismatched and matched unrelated hematopoietic cell transplant (HCT). However, data comparing outcomes of PTCY or ATG in patients undergoing a 1 antigen mismatched HCT for lymphoproliferative disease are limited. We compared PTCY versus ATG in adult patients with lymphoproliferative disease undergoing a first 9/10 MMUD HCT with a reduced intensity conditioning regimen from 2010 to 2021. Patients receiving PTCY were matched to patients receiving ATG according to: age, disease status at transplant, female to male matching, stem cell source and CMV serology. Grade II-IV acute GvHD at 100 day was 26% and 41% for the ATG and PTCY group, respectively (p = 0.08). Grade III–IV acute GvHD was not significantly different between the two groups. No differences were observed in relapse incidence, non-relapse mortality, progression-free survival, overall survival and GvHD-relapse-free survival at 1 year. The cumulative incidence of 1-year extensive chronic GvHD was 18% in the ATG and 5% in the PTCY group, respectively (p = 0.06). In patients with lymphoproliferative diseases undergoing 9/10 MMUD HCT, PTCY might be a safe option providing similar results to ATG prophylaxis. Due to the limited number of patients, prospective randomized trials are needed.