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

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 mismat...

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Detalhes bibliográficos
Autores: Bailen, R, Kwon, M, Pascual-Cascon, MJ, Ferra, C, Sanz, J, Gallardo-Morillo, A, Garcia-Sola, A, Torrent, A, Jimenez-Lorenzo, MJ, Pinana, JL, Montoro, J, Oarbeascoa, G, Dorado, N, Gomez-Centurion, I, Munoz, C, Martinez-Laperche, C, Anguita, J, Buno, I, Diez-Martin, JL, Grp Espanol Trasplante Hematopoyet
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2021
País:España
Recursos:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p15161
Acesso em linha:https://incliva.portalinvestigacion.com/publicaciones/15161
Access Level:acceso abierto
Palavra-chave:GVHD prophylaxis
Post-transplant cyclophosphamide
Unrelated donor HSCT
Descrição
Resumo: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.

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