Post-transplant cyclophosphamide for GVHD prophylaxis compared to ATG-based prophylaxis in unrelated donor transplantation.

Autor: Bailén R; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain. rebeca.bailen@salud.madrid.org.; Gregorio Marañón Health Research Institute, Madrid, Spain. rebeca.bailen@salud.madrid.org., Kwon M; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain., Pascual-Cascón MJ; Department of Hematology and Hemotherapy, Hospital Regional Universitario de Málaga, Málaga, Spain., Ferrà C; Department of Hematology and Hemotherapy, Institut Català d'Oncologia Badalona, Barcelona, Spain., Sanz J; Department of Hematology and Hemotherapy, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Gallardo-Morillo A; Department of Hematology and Hemotherapy, Hospital Regional Universitario de Málaga, Málaga, Spain., García-Sola A; Department of Hematology and Hemotherapy, Hospital Regional Universitario de Málaga, Málaga, Spain., Torrent A; Department of Hematology and Hemotherapy, Institut Català d'Oncologia Badalona, Barcelona, Spain., Jiménez-Lorenzo MJ; Department of Hematology and Hemotherapy, Institut Català d'Oncologia Badalona, Barcelona, Spain., Piñana JL; Department of Hematology and Hemotherapy, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Montoro J; Department of Hematology and Hemotherapy, Hospital Universitario y Politécnico La Fe, Valencia, Spain., Oarbeascoa G; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain., Dorado N; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain., Gómez-Centurión I; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Muñoz C; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain., Martínez-Laperche C; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain., Anguita J; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain.; Universidad Complutense de Madrid, Madrid, Spain., Buño I; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain., Díez-Martín JL; Department of Hematology and Hemotherapy, Hospital General Universitario Gregorio Marañón, Madrid, Spain.; Gregorio Marañón Health Research Institute, Madrid, Spain.; Universidad Complutense de Madrid, Madrid, Spain.
Jazyk: angličtina
Zdroj: Annals of hematology [Ann Hematol] 2021 Feb; Vol. 100 (2), pp. 541-553. Date of Electronic Publication: 2020 Nov 02.
DOI: 10.1007/s00277-020-04317-7
Abstrakt: 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.
Databáze: MEDLINE
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