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Graft-versus-Host Disease Prophylaxis with Post-Transplantation Cyclophosphamide versus Cyclosporine A and Methotrexate in Matched Sibling Donor Transplantation
- Source :
- Transplantation and cellular therapy, 28(2), 86.e1-86.e8, Nagler, A, Labopin, M, Dholaria, B, Wu, D, Choi, G, Aljurf, M, Ciceri, F, Gedde-Dahl, T, Meijer, E, Niittyvuopio, R, Bondarenko, S, Bourhis, J H, Cornelissen, J J, Socié, G, Koc, Y, Canaani, J, Savani, B, Bug, G, Spyridonidis, A, Giebel, S, Brissot, E, Bazarbachi, A, Esteve, J & Mohty, M 2021, ' Graft-versus-Host Disease Prophylaxis with Post-Transplantation Cyclophosphamide versus Cyclosporine A and Methotrexate in Matched Sibling Donor Transplantation ', Transplantation and Cellular Therapy . https://doi.org/10.1016/j.jtct.2021.11.013, Transplantation and Cellular Therapy. Elsevier BV, Transplantation and Cellular Therapy, 28(2), 86.e1-86.e8. Elsevier Inc.
- Publication Year :
- 2022
- Publisher :
- Elsevier BV, 2022.
-
Abstract
- Cyclosporine A (CSA) and methotrexate (MTX) is the standard graft-versus-host disease (GVHD) prophylaxis regimen for matched sibling donor (MSD) allogeneic hematopoietic cell transplantation (allo-HCT). Recently, post-transplantation cyclophosphamide (PTCy) has been shown to be effective in GVHD prevention. In this registry-based study, we compared outcomes of 118 patients treated with PTCy and 1202 patients with CSA/MTX who underwent MSD allo-HCT for acute myelogenous leukemia. In a matched-pair analysis, PTCy was associated with a higher incidence of relapse at 2 years compared with CSA/MTX (41.1% versus 21.3%; P = .039). The incidences of day +180 grade II-IV acute GVHD and 2-year chronic GVHD were comparable in the PTCy and CSA/MTX arms (25.2% versus 25.4% [P = .90] and 42.6% versus 42.6% [P = .84], respectively). Similarly, 2-year leukemia-free survival (LFS; 54.4% versus 74.32%; P = .052), overall survival (OS; 70.6% versus 79.7%; P = .15), and GVHD-free relapse-free survival (GRFS; 38.1% versus 52.5%; P = .49) were not statistically different in the 2 arms. Our data show that GVHD prophylaxis with PTCy is feasible, resulting in similar incidences of GVHD, GRFS, LFS, and OS as seen with conventional CSA/MTX in patients undergoing allo-HCT from an MSD. The higher rate of relapse observed with PTCy needs further evaluation in a prospective study. © 2021 American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc.
- Subjects :
- medicine.medical_specialty
Transplantation Conditioning
Cyclophosphamide
Graft vs Host Disease
Acute myelogenous leukemia
Graft-versus-host disease
Gastroenterology
Recurrence
immune system diseases
Internal medicine
medicine
Humans
Immunology and Allergy
Post-transplantation cyclophosphamide
Prospective Studies
Prospective cohort study
Acute leukemia
Transplantation
business.industry
Siblings
Incidence (epidemiology)
Cell Biology
Hematology
Allogeneic hematopoietic cell transplantation
medicine.disease
United States
Leukemia, Myeloid, Acute
Regimen
Methotrexate
surgical procedures, operative
Cyclosporine
Molecular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 26666367
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Transplantation and Cellular Therapy
- Accession number :
- edsair.doi.dedup.....1e630b2fa43f97f478cb5c0c59c92e2a
- Full Text :
- https://doi.org/10.1016/j.jtct.2021.11.013