Antithymocyte globulin plus post-transplant cyclophosphamide combination as graft-versus-host disease prophylaxis in haploidentical peripheral blood stem cell transplantation for hematological malignancies

Background Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is un...

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Published inInternational journal of hematology Vol. 115; no. 4; pp. 525 - 533
Main Authors Chen, Tzu-Ting, Lin, Ching-Chan, Lo, Wen-Jyi, Hsieh, Ching-Yun, Lien, Ming-Yu, Lin, Che-Hung, Lin, Chen-Yuan, Bai, Li-Yuan, Chiu, Chang-Fang, Yeh, Su-Peng
Format Journal Article
LanguageEnglish
Published Singapore Springer Singapore 01.04.2022
Springer Nature B.V
Subjects
Antilymphocyte serum
Antilymphocyte Serum - therapeutic use
Blood
Blood cancer
Calcineurin
Calcineurin inhibitors
Cyclophosphamide
Cyclophosphamide - therapeutic use
Disease prevention
Epstein-Barr virus
Epstein-Barr Virus Infections - drug therapy
Globulins
Graft versus host disease
Graft vs Host Disease - drug therapy
Graft vs Host Disease - etiology
Graft vs Host Disease - prevention & control
Graft-versus-host reaction
Hematologic Neoplasms - pathology
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic stem cells
Herpesvirus 4, Human
Humans
Immunoproliferative diseases
Lymphocytes
Malignancy
Medicine
Medicine & Public Health
Oncology
Original Article
Peripheral blood
Peripheral Blood Stem Cell Transplantation - adverse effects
Prophylaxis
Rapamycin
Retrospective Studies
Stem cell transplantation
Stem cells
Strategy
Thymocytes
Transplantation
Transplantation Conditioning
ATG
Sirolimus
Haploidentical PBSCT
Online AccessGet full text
ISSN0925-5710
1865-3774
1865-3774
DOI10.1007/s12185-021-03280-x

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Abstract Background Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is unclear, and an optimal strategy for GVHD prophylaxis is needed. Materials and methods We retrospectively analyzed 61 hematologic malignancy patients who underwent peripheral blood haploSCT using ATG/PT-Cy from January 2013 to December 2018. We also compared the effects of ATG/PT-Cy (ATG group; n  = 61) with historical data from patients who underwent haploSCT using sirolimus/PT-Cy (non-ATG group; n  = 22). Results Cumulative incidences of grades II–IV acute GVHD and moderate to severe chronic GVHD did not differ significantly. The ATG group had higher incidence of Epstein–Barr virus (EBV) reactivation, but neither group had post-transplant lymphoproliferative disorders. The ATG group also had a higher OS rate (2-year OS in ATG group vs. non-ATG group: 43.4% vs. 27.3%, respectively; P  = 0.071). Conclusion ATG/PT-Cy is an acceptable strategy for GVHD prophylaxis in Asian patients undergoing haploSCT.
AbstractList Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is unclear, and an optimal strategy for GVHD prophylaxis is needed.BACKGROUNDPost-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is unclear, and an optimal strategy for GVHD prophylaxis is needed.We retrospectively analyzed 61 hematologic malignancy patients who underwent peripheral blood haploSCT using ATG/PT-Cy from January 2013 to December 2018. We also compared the effects of ATG/PT-Cy (ATG group; n = 61) with historical data from patients who underwent haploSCT using sirolimus/PT-Cy (non-ATG group; n = 22).MATERIALS AND METHODSWe retrospectively analyzed 61 hematologic malignancy patients who underwent peripheral blood haploSCT using ATG/PT-Cy from January 2013 to December 2018. We also compared the effects of ATG/PT-Cy (ATG group; n = 61) with historical data from patients who underwent haploSCT using sirolimus/PT-Cy (non-ATG group; n = 22).Cumulative incidences of grades II-IV acute GVHD and moderate to severe chronic GVHD did not differ significantly. The ATG group had higher incidence of Epstein-Barr virus (EBV) reactivation, but neither group had post-transplant lymphoproliferative disorders. The ATG group also had a higher OS rate (2-year OS in ATG group vs. non-ATG group: 43.4% vs. 27.3%, respectively; P = 0.071).RESULTSCumulative incidences of grades II-IV acute GVHD and moderate to severe chronic GVHD did not differ significantly. The ATG group had higher incidence of Epstein-Barr virus (EBV) reactivation, but neither group had post-transplant lymphoproliferative disorders. The ATG group also had a higher OS rate (2-year OS in ATG group vs. non-ATG group: 43.4% vs. 27.3%, respectively; P = 0.071).ATG/PT-Cy is an acceptable strategy for GVHD prophylaxis in Asian patients undergoing haploSCT.CONCLUSIONATG/PT-Cy is an acceptable strategy for GVHD prophylaxis in Asian patients undergoing haploSCT.
Background Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is unclear, and an optimal strategy for GVHD prophylaxis is needed. Materials and methods We retrospectively analyzed 61 hematologic malignancy patients who underwent peripheral blood haploSCT using ATG/PT-Cy from January 2013 to December 2018. We also compared the effects of ATG/PT-Cy (ATG group; n  = 61) with historical data from patients who underwent haploSCT using sirolimus/PT-Cy (non-ATG group; n  = 22). Results Cumulative incidences of grades II–IV acute GVHD and moderate to severe chronic GVHD did not differ significantly. The ATG group had higher incidence of Epstein–Barr virus (EBV) reactivation, but neither group had post-transplant lymphoproliferative disorders. The ATG group also had a higher OS rate (2-year OS in ATG group vs. non-ATG group: 43.4% vs. 27.3%, respectively; P  = 0.071). Conclusion ATG/PT-Cy is an acceptable strategy for GVHD prophylaxis in Asian patients undergoing haploSCT.
BackgroundPost-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is unclear, and an optimal strategy for GVHD prophylaxis is needed.Materials and methodsWe retrospectively analyzed 61 hematologic malignancy patients who underwent peripheral blood haploSCT using ATG/PT-Cy from January 2013 to December 2018. We also compared the effects of ATG/PT-Cy (ATG group; n = 61) with historical data from patients who underwent haploSCT using sirolimus/PT-Cy (non-ATG group; n = 22).ResultsCumulative incidences of grades II–IV acute GVHD and moderate to severe chronic GVHD did not differ significantly. The ATG group had higher incidence of Epstein–Barr virus (EBV) reactivation, but neither group had post-transplant lymphoproliferative disorders. The ATG group also had a higher OS rate (2-year OS in ATG group vs. non-ATG group: 43.4% vs. 27.3%, respectively; P = 0.071).ConclusionATG/PT-Cy is an acceptable strategy for GVHD prophylaxis in Asian patients undergoing haploSCT.
Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the risk of acute/chronic graft-versus-host disease (GVHD). Whether ATG/PT-Cy is feasible for Asian patients undergoing haploSCT is unclear, and an optimal strategy for GVHD prophylaxis is needed. We retrospectively analyzed 61 hematologic malignancy patients who underwent peripheral blood haploSCT using ATG/PT-Cy from January 2013 to December 2018. We also compared the effects of ATG/PT-Cy (ATG group; n = 61) with historical data from patients who underwent haploSCT using sirolimus/PT-Cy (non-ATG group; n = 22). Cumulative incidences of grades II-IV acute GVHD and moderate to severe chronic GVHD did not differ significantly. The ATG group had higher incidence of Epstein-Barr virus (EBV) reactivation, but neither group had post-transplant lymphoproliferative disorders. The ATG group also had a higher OS rate (2-year OS in ATG group vs. non-ATG group: 43.4% vs. 27.3%, respectively; P = 0.071). ATG/PT-Cy is an acceptable strategy for GVHD prophylaxis in Asian patients undergoing haploSCT.
Author Lien, Ming-Yu
Lin, Ching-Chan
Lo, Wen-Jyi
Lin, Che-Hung
Lin, Chen-Yuan
Chen, Tzu-Ting
Bai, Li-Yuan
Hsieh, Ching-Yun
Chiu, Chang-Fang
Yeh, Su-Peng
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BackLink https://www.ncbi.nlm.nih.gov/pubmed/35226308$$D View this record in MEDLINE/PubMed
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Snippet Background Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT)...
Post-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT) increase the...
BackgroundPost-transplant cyclophosphamide (PT-Cy) and calcineurin inhibitors used in peripheral blood haplo-identical stem cell transplantation (haploSCT)...
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SubjectTerms Antilymphocyte serum
Antilymphocyte Serum - therapeutic use
Blood
Blood cancer
Calcineurin
Calcineurin inhibitors
Cyclophosphamide
Cyclophosphamide - therapeutic use
Disease prevention
Epstein-Barr virus
Epstein-Barr Virus Infections - drug therapy
Globulins
Graft versus host disease
Graft vs Host Disease - drug therapy
Graft vs Host Disease - etiology
Graft vs Host Disease - prevention & control
Graft-versus-host reaction
Hematologic Neoplasms - pathology
Hematology
Hematopoietic Stem Cell Transplantation - adverse effects
Hematopoietic stem cells
Herpesvirus 4, Human
Humans
Immunoproliferative diseases
Lymphocytes
Malignancy
Medicine
Medicine & Public Health
Oncology
Original Article
Peripheral blood
Peripheral Blood Stem Cell Transplantation - adverse effects
Prophylaxis
Rapamycin
Retrospective Studies
Stem cell transplantation
Stem cells
Strategy
Thymocytes
Transplantation
Transplantation Conditioning
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Title Antithymocyte globulin plus post-transplant cyclophosphamide combination as graft-versus-host disease prophylaxis in haploidentical peripheral blood stem cell transplantation for hematological malignancies
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