Sara Redondo, Irene García-Cadenas, Albert Esquirol, J. M. Portos, Eva Iranzo, Miguel Arguello-Tomas, Silvana Saavedra, Guadalupe Oñate, Ana-Carolina Caballero, Ana Garrido, Jordi López, Ana Muntañola, Annalisa Paviglianiti, Sara Miqueleiz, Jorge Sierra, Javier Briones, Rodrigo Martino
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Fifty-eight (26%) received prophylaxis with calcineurin inhibitor in combination with mycophenolate mofetil or a short course of methotrexate (Cohort-1), 87 (38%) tacrolimus plus sirolimus (Cohort-2), and 81 (36%) post-transplant cyclophosphamide (PTCy) plus tacrolimus (Cohort-3).</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The incidence of grade II-IV aGvHD was 69% vs. 41.4% vs. 27.2%; <i>p <</i> .01. The most significant reduction with PTCy was observed in both stage 3–4 skin and lower gastrointestinal (GI) involvement (<i>p <</i> .01). The incidence of moderate-to-severe cGvHD at 12 months was 34.5% vs. 34.5% vs. 6.2%; <i>p</i> < .01. Moderate-to-severe skin and GI cGvHD was less common after PTCy (<i>p</i> < .01). The 1-year GvHD-free/relapse-free survival was higher with PTCy (<i>p</i> < .01).</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our study indicates that PTCy-based GvHD prophylaxis reduces the frequency and severity of both acute and chronic GvHD, with a notable decrease in severe GI and cutaneous manifestations. The higher GRFS may result in lower GvHD-related mortality, leading to an improved quality of life among survivors.</p>\n </section>\n </div>","PeriodicalId":11955,"journal":{"name":"European Journal of Haematology","volume":"113 6","pages":"776-787"},"PeriodicalIF":2.3000,"publicationDate":"2024-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Severity and organ distribution of graft-versus-host disease with post-transplant cyclophosphamide versus calcineurin inhibitor plus methotrexate/mycophenolate mofetil or sirolimus in allogenic HLA-matched or single-allele mismatched stem cell transplantation\",\"authors\":\"Sara Redondo, Irene García-Cadenas, Albert Esquirol, J. M. 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引用次数: 0
摘要
目的:本研究是一项回顾性单中心研究,旨在通过比较 3 种不同的 GvHD 预防方法,描述 GvHD 的严重程度和器官特异性分布的变化:这项回顾性单中心研究旨在通过比较3种不同的GvHD预防方法的结果,描述GvHD严重程度和器官特异性分布的变化:2012年1月至2022年6月期间,226名患者接受了HLA匹配或1个等位基因不匹配的亲缘或非亲缘供者的异基因造血干细胞移植。58名患者(26%)接受了钙神经蛋白抑制剂联合霉酚酸酯或短期甲氨蝶呤的预防治疗(队列-1),87名患者(38%)接受了他克莫司加西罗莫司的预防治疗(队列-2),81名患者(36%)接受了移植后环磷酰胺(PTCy)加他克莫司的预防治疗(队列-3):结果:II-IV 级 aGvHD 的发生率为 69% vs. 41.4% vs. 27.2%; p 结论:我们的研究表明,以 PTCy 为基础的 GvHD 预防可降低急性和慢性 GvHD 的发生率和严重程度,其中严重消化道和皮肤表现明显减少。较高的GRFS可能会降低与GvHD相关的死亡率,从而提高幸存者的生活质量。
Severity and organ distribution of graft-versus-host disease with post-transplant cyclophosphamide versus calcineurin inhibitor plus methotrexate/mycophenolate mofetil or sirolimus in allogenic HLA-matched or single-allele mismatched stem cell transplantation
Objective
This retrospective single center study aims to describe changes in the severity and organ-specific distribution of GvHD, by comparing the outcomes of 3 distinct GvHD prophylaxis approaches.
Methods
Between January 2012 and June 2022, 226 patients underwent allogeneic hematopoietic stem cell transplantation from HLA-matched or 1-allele mismatched related or unrelated donors. Fifty-eight (26%) received prophylaxis with calcineurin inhibitor in combination with mycophenolate mofetil or a short course of methotrexate (Cohort-1), 87 (38%) tacrolimus plus sirolimus (Cohort-2), and 81 (36%) post-transplant cyclophosphamide (PTCy) plus tacrolimus (Cohort-3).
Results
The incidence of grade II-IV aGvHD was 69% vs. 41.4% vs. 27.2%; p < .01. The most significant reduction with PTCy was observed in both stage 3–4 skin and lower gastrointestinal (GI) involvement (p < .01). The incidence of moderate-to-severe cGvHD at 12 months was 34.5% vs. 34.5% vs. 6.2%; p < .01. Moderate-to-severe skin and GI cGvHD was less common after PTCy (p < .01). The 1-year GvHD-free/relapse-free survival was higher with PTCy (p < .01).
Conclusions
Our study indicates that PTCy-based GvHD prophylaxis reduces the frequency and severity of both acute and chronic GvHD, with a notable decrease in severe GI and cutaneous manifestations. The higher GRFS may result in lower GvHD-related mortality, leading to an improved quality of life among survivors.
期刊介绍:
European Journal of Haematology is an international journal for communication of basic and clinical research in haematology. The journal welcomes manuscripts on molecular, cellular and clinical research on diseases of the blood, vascular and lymphatic tissue, and on basic molecular and cellular research related to normal development and function of the blood, vascular and lymphatic tissue. The journal also welcomes reviews on clinical haematology and basic research, case reports, and clinical pictures.