1. Post-transplant cyclophosphamide at 80 mg/kg with low dose post-engraftment anti-thymocyte globulin in haploidentical transplantation with myeloablative conditioning.
- Author
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Wang L, Xu G, Wang L, Jiang J, Gao W, Wan M, Blaise D, and Hu J
- Subjects
- Humans, Male, Female, Middle Aged, Retrospective Studies, Hematopoietic Stem Cell Transplantation methods, Aged, Adult, Cyclophosphamide therapeutic use, Cyclophosphamide administration & dosage, Transplantation Conditioning methods, Antilymphocyte Serum therapeutic use, Antilymphocyte Serum administration & dosage, Graft vs Host Disease prevention & control, Transplantation, Haploidentical methods
- Abstract
While post-transplant cyclophosphamide (PTCy) is commonly used as graft-versus-host disease (GvHD) prophylaxis in haploidentical stem cell transplantation (haplo-HSCT), its dose remains a matter of debate due to side effect concerns. Standard dose of 100 mg/kg associated with tacrolimus and post-engraftment anti-thymocyte globulin (ATG) was used as the reference GvHD prophylaxis in our center and had demonstrated encouraging results. Though PTCy 80 mg/kg was shown to be feasible in patients in reduced-intensity conditioning, whether it exerts equivalent GvHD prophylactic efficacy in myeloablative conditioning (MAC) setting has not been confirmed. Here, we retrospectively analyzed the efficacy and safety of PTCy 80 mg/kg combined with tacrolimus and post-engraftment ATG as GvHD prophylaxis in patients aged more than 55 years or with cardiac antecedents or HCT-CI score >2 undergoing haplo-HSCT with MAC. The cumulative incidence of grade III-IV aGvHD at day 100 and moderate-to-severe cGvHD at 1 year was 4.8% ± 3.4% and 19.9% ± 7.0%, respectively. When compared with patients receiving the reference regimen, patients from the PTCy 80 mg/kg group had similar incidence of GvHDs and survival as their younger counterparts. Thus, PTCy 80 mg/kg seems to be feasible for patients treated with MAC conditioning regimens in haplo-HSCT, inviting further investigation notably in frail patients., (© 2024. The Author(s), under exclusive licence to Springer Nature Limited.)
- Published
- 2024
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