Post-Transplant Cyclophosphamide versus Anti-Thymocyte Globulin in Patients with Hematological Malignancies Treated with Allogeneic Hematopoietic Stem Cell Transplantation from Haploidentical and Matched Unrelated Donors: A Real-Life Experience.

Autor: Serio B; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy., Storti G; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., D'Addona M; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy.; Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy., Santoro L; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Frieri C; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., De Novellis D; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy.; Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy., Marano L; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., De Santis G; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Guariglia R; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy., Manfra I; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Urciuoli E; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Luponio S; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy., Marotta S; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Morini D; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy., Rizzo M; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy., Palmieri F; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Cantore N; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Giudice V; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy.; Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy., Risitano AM; Hematology Unit, Hospital 'S. Giuseppe Moscati', 83100 Avellino, Italy., Selleri C; Hematology Unit, University Hospital 'San Giovanni di Dio e Ruggi d'Aragona', 84131 Salerno, Italy.; Department of Medicine, Surgery, and Dentistry, University of Salerno, 84081 Baronissi, Italy.
Jazyk: angličtina
Zdroj: Hematology reports [Hematol Rep] 2024 Apr 17; Vol. 16 (2), pp. 234-243. Date of Electronic Publication: 2024 Apr 17.
DOI: 10.3390/hematolrep16020023
Abstrakt: Background: Post-transplant cyclophosphamide (PTCY) is widely used as graft versus host disease (GvHD) prophylaxis in allogeneic hematopoietic stem cell transplant (HSCT) recipients, with reported clinical benefits in patients who underwent transplant from a matched unrelated donor (MUD). However, real-life data on clinical efficacy and safety of PTCY in haploidentical and MUD transplantations are still poor. Methods: In our real-life retrospective observational study, we included a total of 40 consecutive adult patients who underwent haploidentical or MUD HSCT for various hematological malignancies and who received PTCY ( n = 24) or ATG ( n = 16) as GvHD prophylaxis at Hematology Units from hospitals of Salerno and Avellino, Italy, and clinical outcomes were compared. Results: We showed protective effects of PTCY against disease relapse with the relapse rate after transplantation of 16% versus 50% in the ATG arm ( p = 0.02). All-cause mortality was lower (36% vs. 75%; p = 0.02) and the 2-year overall survival was slightly superior in patients administered PTCY (61% vs. 42%; p = 0.26). Conclusions: We support the use of PTCY, even in a real-life setting; however, the optimization of this protocol should be further investigated to better balance relapse prevention and GvHD prophylaxis.
Databáze: MEDLINE
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