Feasibility and efficacy of partial replacement of post transplantation cyclophosphamide with bendamustine on day +4 for graft versus host disease prophylaxis in patients undergoing allogeneic hematopoietic cell transplantation.

IF 4.5 2区医学 Q1 HEMATOLOGY

Bone Marrow Transplantation Pub Date : 2025-04-21 DOI:10.1038/s41409-025-02581-7

Velu Nair, Manthan Kathrotiya, Vijaykumar Shirure, Shruti Bhise, Sandip Kheni, Jayani Patel, Neha Motwani, Dhara Shah, Grishma Sukhwal, Chaitrangi Paranjape, Vivek Nair, Anshul Warman, Seema Patrikar, Uday Yanamandra

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引用次数: 0

Abstract

PT-CY use in T cell-replete haploidentical HCT has significantly improved outcomes. However, hyperhydration with MESNA in CY administration poses a challenge, in patients with cardiac/ renal problems. PT-CY also increases VOD risk with prior exposure to hepatotoxic drugs. Katsanis et al. in a phase Ia trial in patients undergoing HCT for hematological malignancies showed that partially replacing PT-CY with PT-BEN had comparable outcomes to conventional PT-CY. We conducted an ambispective study in 54 patients [haplo (39), MSD(14), and MUD(1)] with nonmalignant hematological disorders and hematological malignancies in pediatric and adult patients undergoing HCT (MAC/RIC) from February 2019 to May 2024. GvHD prophylaxis comprised of PT-CY/BEN (PT-CY 50 mg/kg Day +3; PT-BEN 90 mg/m² Day +4) in a prospective arm (n = 21) and PT-CY/CY (50 mg/kg on Days +3, +4; comparator arm) in ambispective (prospective 12; retrospective 21) arm. In both groups, immunosuppression with CNI and MMF was also given. PT-CY/BEN was comparable to PT-CY/CY in terms of safety, efficacy, and GVHD prevention. In the PT-CY/BEN group, there was earlier neutrophil (0.008) and platelet (0.0057) engraftment with significantly lower BK viremia. Incidence of bacterial infection, TRM, EFS, and OS were comparable in both groups.

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异基因造血细胞移植患者移植后第4天部分替代环磷酰胺苯达莫司汀预防移植物抗宿主病的可行性和有效性

PT-CY用于充满T细胞的单倍体HCT可显著改善预后。然而，在有心脏/肾脏问题的患者中，CY给药时MESNA的过度水化带来了挑战。PT-CY还会增加先前暴露于肝毒性药物的VOD风险。Katsanis等人在接受HCT治疗血液恶性肿瘤患者的Ia期试验中表明，用PT-BEN部分替代PT-CY与常规PT-CY的结果相当。我们对2019年2月至2024年5月接受HCT （MAC/RIC）治疗的54例患有非恶性血液疾病和血液恶性肿瘤的儿童和成人患者进行了一项双侧研究[haplo (39)， MSD（14）和MUD(1)]。预防GvHD包括PT-CY/BEN (PT-CY 50 mg/kg Day +3；PT-BEN 90 mg/m2 Day +4)和PT-CY/CY (50 mg/kg Days +3, +4；双透视比较组)(前瞻性12；回顾臂。两组均给予CNI和MMF免疫抑制。PT-CY/BEN在安全性、有效性和GVHD预防方面与PT-CY/CY相当。PT-CY/BEN组中性粒细胞（0.008）和血小板（0.0057）植入较早，BK病毒血症明显降低。两组的细菌感染、TRM、EFS和OS发生率均具有可比性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone Marrow Transplantation 医学-免疫学

CiteScore

8.40

自引率

8.30%

发文量

337

审稿时长

6 months

期刊介绍： Bone Marrow Transplantation publishes high quality, peer reviewed original research that addresses all aspects of basic biology and clinical use of haemopoietic stem cell transplantation. The broad scope of the journal thus encompasses topics such as stem cell biology, e.g., kinetics and cytokine control, transplantation immunology e.g., HLA and matching techniques, translational research, and clinical results of specific transplant protocols. Bone Marrow Transplantation publishes 24 issues a year.