1. A Modified Post-Transplant Cyclophosphamide Regimen, for Unmanipulated Haploidentical Marrow Transplantation, in Acute Myeloid Leukemia: A Multicenter Study.
- Author
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Chiusolo, Patrizia, Bug, Gesine, Olivieri, Attilio, Brune, Mats, Mordini, Nicola, Alessandrino, Paolo Emilio, Dominietto, Alida, Raiola, Anna Maria, Di Grazia, Carmen, Gualandi, Francesca, Van Lint, Maria Teresa, Ferrara, Felicetto, Finizio, Olimpia, Angelucci, Emanuele, and Bacigalupo, Andrea
- Subjects
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ACUTE myeloid leukemia treatment , *CYCLOPHOSPHAMIDE , *STEM cell transplantation , *MYELOSUPPRESSION , *CYCLOSPORINE , *THERAPEUTICS - Abstract
We report a modified post-transplant cyclophosphamide (PT-CY) regimen, for unmanipulated haploidentical marrow transplants, in 150 patients with acute myeloid leukemia (AML). All patients received a myeloablative regimen, cyclosporine A (CsA) on day 0, mycophenolate on day +1, and PT-CY 50 mg/kg on days +3 and +5. The median age was 51 (range, 17–74) years, 51 (34%) patients had active disease at transplant, and the median follow-up of surviving patients 903 (range, 150-1955) days. The cumulative incidence (CI) of engraftment, acute graft-versus-host disease (GVHD) grade II to IV, and moderate/severe chronic GVHD was 92%, 17%, and 15%, respectively. The 4-year CI of transplant-related mortality (TRM) and relapse was 20% and 24%, respectively. Four-year survival for remission patients was 72% (74% versus 67% for <60 or ≥60 years of age) and 26% for advanced patients (17% versus 41% for <60 or ≥60 years of age). In a multivariate analysis, active disease at transplant was the only negative predictor of survival, TRM and relapse. The original PT-CY regimen can be modified with CsA on day 0, still providing protection against GVHD, low toxicity, and encouraging low relapse incidence in AML patients, also over 60 years of age. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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