Back to Search
Start Over
Post-transplant cyclophosphamide for GVHD prophylaxis compared to ATG-based prophylaxis in unrelated donor transplantation.
- Source :
-
Annals of hematology [Ann Hematol] 2021 Feb; Vol. 100 (2), pp. 541-553. Date of Electronic Publication: 2020 Nov 02. - Publication Year :
- 2021
-
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.
- Subjects :
- Adolescent
Adult
Aged
Allografts
Disease-Free Survival
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Retrospective Studies
Survival Rate
Antilymphocyte Serum administration & dosage
Cyclophosphamide administration & dosage
Graft vs Host Disease mortality
Graft vs Host Disease prevention & control
Peripheral Blood Stem Cell Transplantation
Unrelated Donors
Subjects
Details
- Language :
- English
- ISSN :
- 1432-0584
- Volume :
- 100
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Annals of hematology
- Publication Type :
- Academic Journal
- Accession number :
- 33140137
- Full Text :
- https://doi.org/10.1007/s00277-020-04317-7