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Post-transplant cyclophosphamide, calcineurin inhibitor, and mycophenolate mofetil compared to anti-thymocyte globulin, calcineurin inhibitor, and methotrexate combinations as graft-versus-host disease prophylaxis post allogeneic stem cell transplantation from sibling and unrelated donors in patients with acute myeloid leukemia: a study on behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Post-transplant cyclophosphamide plus calcineurin inhibitor (CNI)(tacrolimus or cyclosporine A) plus mycophenolate mofetil (PTCy/TAC or CSA/MMF) and anti-thymocyte globulin plus CNI (tacrolimus or cyclosporine A) plus methotrexate (ATG/TAC or CSA/MTX) are common graft-versus-host disease (GVHD) prop...

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Main Authors: Nagler, Arnon (Author) , Labopin, Myriam (Author) , Swoboda, Ryszard (Author) , Schroeder, Thomas (Author) , Hamladji, Rose-Marie (Author) , Griskevicius, Laimonas (Author) , Salmenniemi, Urpu (Author) , Rambaldi, Alessandro (Author) , Mielke, Stephan (Author) , Kulagin, Alexander (Author) , Passweg, Jakob R. (Author) , Luft, Thomas (Author) , Gedde-Dahl, Tobias (Author) , Forcade, Edouard (Author) , Helbig, Grzegorz (Author) , Stelljes, Matthias (Author) , Castilla-Llorente, Cristina (Author) , Spyridonidis, Alexandros (Author) , Brissot, Eolia (Author) , Ciceri, Fabio (Author) , Mohty, Mohamad (Author)
Format: Article (Journal)
Language:English
Published: July 2024
In: Bone marrow transplantation
Year: 2024, Volume: 59, Issue: 7, Pages: 1012-1021
ISSN:1476-5365
DOI:10.1038/s41409-024-02284-5
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1038/s41409-024-02284-5
Verlag, lizenzpflichtig, Volltext: https://www.nature.com/articles/s41409-024-02284-5
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Author Notes:Arnon Nagler, Myriam Labopin, Ryszard Swoboda, Thomas Schroeder, Rose-Marie Hamladji, Laimonas Griskevicius, Urpu Salmenniemi, Alessandro Rambaldi, Stephan Mielke, Alexander Kulagin, Jakob Passweg, Thomas Luft, Tobias Gedde-Dahl, Edouard Forcade, Grzegorz Helbig, Matthias Stelljes, Cristina Castilla-Llorente, Alexandros Spyridonidis, Eolia Brissot, Fabio Ciceri and Mohamad Mohty
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Summary:Post-transplant cyclophosphamide plus calcineurin inhibitor (CNI)(tacrolimus or cyclosporine A) plus mycophenolate mofetil (PTCy/TAC or CSA/MMF) and anti-thymocyte globulin plus CNI (tacrolimus or cyclosporine A) plus methotrexate (ATG/TAC or CSA/MTX) are common graft-versus-host disease (GVHD) prophylaxis regimens. We compared the two regimens in patients with acute myeloid leukemia (AML) undergoing allogeneic transplantation from matched siblings or unrelated donors. 402 received PTCy/TAC or CSA/MMF and 5648 received ATG/TAC or CSA/MTX. Patients in the PTCy-based group were younger (48.7 vs. 51.5 years, p = 0.024) and there was a higher frequency of patient cytomegalovirus seropositivity and female donor to male patient combination in this group (77.8% vs. 71.8%, p = 0.009 and 18.4% vs. 14.4%, p = 0.029, respectively). More patients in the PTCy-based group received reduced-intensity conditioning (51.5% vs. 41%, p < 0.0001). No differences were observed in the incidence of acute GVHD grade II-IV and III-IV (21.2% vs. 20.4%, p = 0.92 and 8.1% vs. 6%, p = 0.1) or 2-year total and extensive chronic GVHD (33.7% vs. 30%, p = 0.09 and 10.7% vs. 11.2%, p = 0.81) between the groups. In the multivariate analysis, all transplant outcomes did not differ between the groups. PTCy/CNI/MMF and ATG/CNI/MTX are alternative regimens for GVHD prophylaxis in AML patients.
Item Description:Online veröffentlicht am 13. April 2024
Gesehen am 24.09.2024
Physical Description:Online Resource
ISSN:1476-5365
DOI:10.1038/s41409-024-02284-5

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