Erschienen in:
02.11.2020 | Original Article
Post-transplant cyclophosphamide for GVHD prophylaxis compared to ATG-based prophylaxis in unrelated donor transplantation
verfasst von:
Rebeca Bailén, Mi Kwon, María Jesús Pascual-Cascón, Christelle Ferrà, Jaime Sanz, Anabel Gallardo-Morillo, Abel García-Sola, Anna Torrent, María José Jiménez-Lorenzo, José Luis Piñana, Juan Montoro, Gillen Oarbeascoa, Nieves Dorado, Ignacio Gómez-Centurión, Cristina Muñoz, Carolina Martínez-Laperche, Javier Anguita, Ismael Buño, José Luis Díez-Martín, on behalf of Grupo Español de Trasplante Hematopoyético y Terapia Celular (GETH)
Erschienen in:
Annals of Hematology
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Ausgabe 2/2021
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Abstract
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.