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Graft-versus-Host Disease Prophylaxis with Post-Transplantation Cyclophosphamide versus Cyclosporine A and Methotrexate in Matched Sibling Donor Transplantation

Authors :
Mahmoud Aljurf
Ellen Meijer
Sergey N. Bondarenko
Sebastian Giebel
Jonathan Canaani
Bhagirathbhai Dholaria
Alexandros Spyridonidis
Arnon Nagler
Jean Bourhis
Tobias Gedde-Dahl
Mohamad Mohty
Depei Wu
Bipin N. Savani
Fabio Ciceri
Myriam Labopin
Eolia Brissot
Jordi Esteve
Riitta Niittyvuopio
Yener Koc
Ali Bazarbachi
Goda Choi
Gesine Bug
Jan J. Cornelissen
Gérard Socié
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.
Socie, G.
Koc, Y.
Canaani, J.
Savani, B.
Bug, G.
Spyridonidis, A.
Giebel, S.
Brissot, E.
Bazarbachi, A.
Esteve, J.
Mohty, M.
Hematology
AII - Inflammatory diseases
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.

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