Bibliographic Details
| Title: |
Posttransplant cyclophosphamide vs cyclosporin A and methotrexate as GVHD prophylaxis in matched sibling transplantation |
| Authors: |
Mi Kwon, Rebeca Bailén, María Jesús Pascual-Cascón, Ana Isabel Gallardo-Morillo, Abel García Sola, Pascual Balsalobre, Laura Solán, Nieves Dorado, Cristina Muñoz, David Serrano, Carolina Martínez-Laperche, Ismael Buño, Javier Anguita, José Luis Díez-Martin |
| Source: |
Blood Advances, Vol 3, Iss 21, Pp 3351-3359 (2019) |
| Publisher Information: |
Elsevier, 2019. |
| Publication Year: |
2019 |
| Collection: |
LCC:Specialties of internal medicine |
| Subject Terms: |
Specialties of internal medicine, RC581-951 |
| More Details: |
Abstract: Posttransplant cyclophosphamide (PTCy) effectively prevents graft-versus-host disease (GVHD) after HLA-haploidentical hematopoietic stem cell transplantation (HSCT). The use of PTCy in HLA-identical HSCT is less explored. We conducted a retrospective study of 107 consecutive patients undergoing an HLA-identical sibling (10/10) HSCT in 2 centers in Spain, 50 with GVHD prophylaxis with methotrexate–cyclosporin A (MTX-CsA) and 57 using a PTCy-based regimen with additional immunosuppression. Graft source was unmanipulated mobilized peripheral blood stem cells (PBSC) in most patients (97 patients, 91%). Cumulative incidences of grade II to IV and III to IV acute GVHD at 100 days were lower in the PTCy group (22.6% vs 52.2%, P = .0015; 8.8% vs 24.4%, P = .016), without statistically significant differences in the 2-year cumulative incidence of chronic moderate to severe GVHD (16.7% vs 26%, P = .306). At 2 years, no statistically significant differences were observed in OS (78% vs 56%, P = .088), EFS (62.5% vs 48%, P = .054), relapse (28% vs 27%, P = .47), and NRM (8.8% vs 24%, P = .054). The composite endpoint of GVHD and relapse-free survival (GRFS) was favorable for the PTCy group (24% vs 48%, P = .011), PTCy being the sole independent factor identified in the multivariate analysis for this endpoint. In this study, PTCy combination with additional immunosuppression using mostly PBSCs grafts showed a reduction of acute GVHD rate and an impact on GRFS, with safety results comparable with those obtained with MTX-CsA. Further prospective studies are needed to confirm these observations.. |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2473-9529 |
| Relation: |
http://www.sciencedirect.com/science/article/pii/S2473952920317961; https://doaj.org/toc/2473-9529 |
| DOI: |
10.1182/bloodadvances.2019000236 |
| Access URL: |
https://doaj.org/article/bcc18912d22c4149aa55b4fa0b81f596 |
| Accession Number: |
edsdoj.bcc18912d22c4149aa55b4fa0b81f596 |
| Database: |
Directory of Open Access Journals |
