Details

Autor(en) / Beteiligte

• Battipaglia, Giorgia
• Labopin, Myriam
• Kröger, Nicolaus
• Vitek, Antonin
• Afanasyev, Boris
• Hilgendorf, Inken
• Schetelig, Johannes
• Ganser, Arnold
• Blaise, Didier
• Itälä-Remes, Maija
• Passweg, Jakob R.
• Bonifazi, Francesca
• Finke, Jurgen
• Ruggeri, Annalisa
• Nagler, Arnon
• Mohty, Mohamad

Titel

Posttransplant cyclophosphamide vs antithymocyte globulin in HLA-mismatched unrelated donor transplantation

Ist Teil von

• Blood, 2019-09, Vol.134 (11), p.892-899

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2019

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• The use of anti-thymocyte globulin (ATG) has represented the standard of care in graft-versus-host disease (GVHD) prophylaxis in patients undergoing a mismatched unrelated donor (MMUD) transplant. The safety and feasibility of posttransplant cyclophosphamide (PTCY) in this setting have been reported recently, but no study has compared the outcomes of PTCY vs ATG in 9/10 MMUD transplants. Using the registry data of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation, we performed a matched-pair analysis comparing those 2 strategies in a 9/10 MMUD setting. Ninety-three patients receiving PTCY were matched with 179 patients receiving ATG. A significantly lower incidence of severe acute GVHD was observed with PTCY compared with ATG. Recipients of the former also showed higher leukemia-free survival and GVHD/relapse-free survival (GRFS). When performing a subgroup analysis including patients receiving peripheral blood stem cells, being in complete remission, or receiving the same associated immunosuppressive agents, superiority of PTCY over ATG was confirmed. Similar to the haploidentical setting, use of PTCY is an effective anti-GVHD prophylaxis in the 9/10 MMUD transplant. Use of PTCY may also provide better outcomes in long-term disease control. These results need confirmation in large prospective randomized trials. •PTCY results in a lower incidence of severe acute GVHD compared with ATG in patients transplanted from 9/10 MMUD for acute myeloid leukemia.•PTCY results in better survival compared with ATG in patients transplanted from 9/10 MMUD for acute myeloid leukemia. [Display omitted]