Low-dose anti-thymocyte globulin plus low-dose posttransplant cyclophosphamide as graft-versus-host disease prophylaxis in haploidentical peripheral blood stem cell transplantation combined with unrelated cord blood for patients with hematologic malignancies: a prospective, phase II study
Autor: | Huixia Liu, Haitao Bai, Jun J. Yang, Shan Shao, Yu Cai, Su Li, Xianmin Song, Chun Wang, Liping Wan, Jieling Jiang, Jun Zhu |
---|---|
Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty Cyclophosphamide Graft vs Host Disease Cord Blood Stem Cell Transplantation Gastroenterology Article Disease-Free Survival 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans Prospective Studies Survival rate Antilymphocyte Serum Peripheral Blood Stem Cell Transplantation Transplantation business.industry Hematology Middle Aged Allografts medicine.disease Stem-cell research Anti-thymocyte globulin Survival Rate Regimen Graft-versus-host disease Hematologic Neoplasms 030220 oncology & carcinogenesis Cord blood Female Unrelated Donors business Haematological diseases 030215 immunology medicine.drug |
Zdroj: | Bone Marrow Transplantation |
ISSN: | 1476-5365 0268-3369 |
Popis: | Nowadays, the most wildly used regimens for graft-versus-host disease (GvHD) prophylaxis in haplo-hematopoietic stem cell transplantation (Haplo-HSCT) are based on in vivo T-cell depletion (TCD) with anti-thymocyte globulin (ATG) or posttransplant cyclophosphamide (PTCy). To improve the efficiency of GvHD prophylaxis in haploidentical peripheral blood stem cell transplantation combined with unrelated cord blood (Haplo-PBSCT-Cord), a novel regimen, which is composed of low dose of ATG (5 mg/kg) and low-dose PTCy (50 mg/kg) for GvHD prophylaxis, was evaluated in a prospective phase II clinical trial (Clinicaltrials.org NCT03395860). Thirty-two patients diagnosed with hematological malignancies were enrolled in this trial. All patients received myeloablative conditioning regimens except for three patients. The cumulative incidences (CIs) of grades II-IV and III-IV acute GvHD were 19.4% (95% CI, 5.5-33.3%) and 6.9% (95% CI, 0-16.3%) by day 100, respectively. The 1-year probability of relapse, disease free survival (DFS) and overall survival (OS) was 25.1% (95% CI, 7.3-42.9%), 59% (95% CI, 33.3-84.7%) and 78.4% (95% CI, 63-93.8%), respectively. The CIs of CMV and EBV reactivation by day 180 were 37.5% (95% CI, 19.8-55.2%) and 40.6% (95% CI, 22.6-58.6%), respectively. The results suggested that low-dose ATG with low-dose PTCy as GvHD prophylaxis in Haplo-PBSCT-Cord had promising activity. |
Databáze: | OpenAIRE |
Externí odkaz: |