Posttransplant cyclophosphamide vs antithymocyte globulin in HLA-mismatched unrelated donor transplantation
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Posttransplant cyclophosphamide vs antithymocyte globulin in HLA-mismatched unrelated donor transplantation. / 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.
in: BLOOD, Jahrgang 134, Nr. 11, 12.09.2019, S. 892-899.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Posttransplant cyclophosphamide vs antithymocyte globulin in HLA-mismatched unrelated donor transplantation
AU - Battipaglia, Giorgia
AU - Labopin, Myriam
AU - Kröger, Nicolaus
AU - Vitek, Antonin
AU - Afanasyev, Boris
AU - Hilgendorf, Inken
AU - Schetelig, Johannes
AU - Ganser, Arnold
AU - Blaise, Didier
AU - Itälä-Remes, Maija
AU - Passweg, Jakob R
AU - Bonifazi, Francesca
AU - Finke, Jurgen
AU - Ruggeri, Annalisa
AU - Nagler, Arnon
AU - Mohty, Mohamad
N1 - © 2019 by The American Society of Hematology.
PY - 2019/9/12
Y1 - 2019/9/12
N2 - 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.
AB - 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.
U2 - 10.1182/blood.2019000487
DO - 10.1182/blood.2019000487
M3 - SCORING: Journal article
C2 - 31270102
VL - 134
SP - 892
EP - 899
JO - BLOOD
JF - BLOOD
SN - 0006-4971
IS - 11
ER -