Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations

This study compared the efficacy of graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide (PTCy) and tacrolimus (Tac) versus other regimens in 272 adults undergoing peripheral blood (PB) allogeneic hematopoietic cell transplantation (allo-HCT) from HLA-matched donor...

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Autores: Salas, María Queralt|||0000-0003-4567-3682, Pedraza, Alexandra|||0000-0002-6039-8140, Charry, Paola|||0000-0002-4777-9643, Suárez-Lledó Grande, María|||0009-0004-4573-0581, Rodríguez Lobato, Luis Gerardo|||0000-0001-5694-0921, Brusosa, M.|||0009-0000-5336-3751, Solano, María Teresa, Serrahima, Anna|||0000-0002-7487-5358, Nomdedeu, Meritxell, Cid, Joan|||0000-0001-5445-4508, Lozano, Miquel|||0000-0003-2593-833X, Arcarons, Jordi|||0000-0002-1356-6260, de Llobet, Noemí|||0009-0004-3515-5632, Rosiñol, Laura|||0000-0002-2534-9239, Esteve Reyner, Jordi|||0000-0002-8056-648X, Urbano Ispizua, Álvaro|||0000-0002-7529-9399, Carreras, E., Fernandez Aviles, Francesc|||0000-0003-3051-3926, Rovira, Montserrat, Martínez, Carmen|||0000-0002-8401-7306
Tipo de documento: artigo
Data de publicação:2024
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:311606
Acesso em linha:https://ddd.uab.cat/record/311606
https://dx.doi.org/urn:doi:10.1016/j.jtct.2023.11.020
Access Level:Acceso aberto
Palavra-chave:Allogeneic stem cell transplantation
Matched related donor
Matched unrelated donor
PTCy/Tac
Peripheral blood stem cell grafts
Post-transplantation cyclophosphamide
Tacrolimus
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repository_id_str
spelling Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than LimitationsSalas, María Queralt|||0000-0003-4567-3682Pedraza, Alexandra|||0000-0002-6039-8140Charry, Paola|||0000-0002-4777-9643Suárez-Lledó Grande, María|||0009-0004-4573-0581Rodríguez Lobato, Luis Gerardo|||0000-0001-5694-0921Brusosa, M.|||0009-0000-5336-3751Solano, María TeresaSerrahima, Anna|||0000-0002-7487-5358Nomdedeu, MeritxellCid, Joan|||0000-0001-5445-4508Lozano, Miquel|||0000-0003-2593-833XArcarons, Jordi|||0000-0002-1356-6260de Llobet, Noemí|||0009-0004-3515-5632Rosiñol, Laura|||0000-0002-2534-9239Esteve Reyner, Jordi|||0000-0002-8056-648XUrbano Ispizua, Álvaro|||0000-0002-7529-9399Carreras, E.Fernandez Aviles, Francesc|||0000-0003-3051-3926Rovira, MontserratMartínez, Carmen|||0000-0002-8401-7306Allogeneic stem cell transplantationMatched related donorMatched unrelated donorPTCy/TacPeripheral blood stem cell graftsPost-transplantation cyclophosphamideTacrolimusThis study compared the efficacy of graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide (PTCy) and tacrolimus (Tac) versus other regimens in 272 adults undergoing peripheral blood (PB) allogeneic hematopoietic cell transplantation (allo-HCT) from HLA-matched donors. Of these 272 patients, 95 (34.9%) received PTCy/Tac. The times to neutrophil and platelet engraftment were longer in the PTCy/Tac group (20 days versus 16 days for neutrophils and 19 days versus 12 days for platelets). The day +30 cumulative incidence (CuI) of bacterial bloodstream infection was higher in the PTCy/Tac group (43.2% versus 13.0%; P <.001). The CuIs of grade II-IV and grade III-IV acute GVHD (aGVHD) at day +180 were 14.7% and 4.2%, and the CuI of moderate/severe cGVHD at 2 years was 2.4% in the PTCy/Tac group and 41.8% (hazard ratio [HR],.29; P <.001), 15.8%, (HR,.24; P =.007), and 47.0% (HR,.05; P <.001), respectively, in the no-PTCy group. The duration of immunosuppression was shorter in patients receiving PTCy/Tac (6.2 months versus 9.0 months; P <.001). PTCy/Tac patients had higher OS (2 years: 74.3% versus 60.9%; HR,.54; P =.012), lower NRM (2 years: 8.6% versus 15.8%; HR,.54; P =.11), comparable CuI of relapse (2 years: 26.0% versus 24.4%; HR, 1.03; P =.89), and higher GRFS (2 years: 59.1% versus 16.7%; HR,.32; P <.001). Using PTCy/Tac in HLA-matched PB allo-HCT improved transplantation outcomes at out institution compared with previous prophylactic regimens, including a higher probability of survival despite more delayed engraftment and a higher rate of bacterial infection.Universitat Autònoma de Barcelona 22024-01-0120242024-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/311606https://dx.doi.org/urn:doi:10.1016/j.jtct.2023.11.020reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3116062026-06-06T12:50:31Z
dc.title.none.fl_str_mv Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
title Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
spellingShingle Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
Salas, María Queralt|||0000-0003-4567-3682
Allogeneic stem cell transplantation
Matched related donor
Matched unrelated donor
PTCy/Tac
Peripheral blood stem cell grafts
Post-transplantation cyclophosphamide
Tacrolimus
title_short Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
title_full Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
title_fullStr Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
title_full_unstemmed Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
title_sort Post-Transplantation Cyclophosphamide and Tacrolimus for Graft-versus-Host Disease Prevention after Allogeneic Hematopoietic Cell Transplantation from HLA-Matched Donors Has More Advantages Than Limitations
dc.creator.none.fl_str_mv Salas, María Queralt|||0000-0003-4567-3682
Pedraza, Alexandra|||0000-0002-6039-8140
Charry, Paola|||0000-0002-4777-9643
Suárez-Lledó Grande, María|||0009-0004-4573-0581
Rodríguez Lobato, Luis Gerardo|||0000-0001-5694-0921
Brusosa, M.|||0009-0000-5336-3751
Solano, María Teresa
Serrahima, Anna|||0000-0002-7487-5358
Nomdedeu, Meritxell
Cid, Joan|||0000-0001-5445-4508
Lozano, Miquel|||0000-0003-2593-833X
Arcarons, Jordi|||0000-0002-1356-6260
de Llobet, Noemí|||0009-0004-3515-5632
Rosiñol, Laura|||0000-0002-2534-9239
Esteve Reyner, Jordi|||0000-0002-8056-648X
Urbano Ispizua, Álvaro|||0000-0002-7529-9399
Carreras, E.
Fernandez Aviles, Francesc|||0000-0003-3051-3926
Rovira, Montserrat
Martínez, Carmen|||0000-0002-8401-7306
author Salas, María Queralt|||0000-0003-4567-3682
author_facet Salas, María Queralt|||0000-0003-4567-3682
Pedraza, Alexandra|||0000-0002-6039-8140
Charry, Paola|||0000-0002-4777-9643
Suárez-Lledó Grande, María|||0009-0004-4573-0581
Rodríguez Lobato, Luis Gerardo|||0000-0001-5694-0921
Brusosa, M.|||0009-0000-5336-3751
Solano, María Teresa
Serrahima, Anna|||0000-0002-7487-5358
Nomdedeu, Meritxell
Cid, Joan|||0000-0001-5445-4508
Lozano, Miquel|||0000-0003-2593-833X
Arcarons, Jordi|||0000-0002-1356-6260
de Llobet, Noemí|||0009-0004-3515-5632
Rosiñol, Laura|||0000-0002-2534-9239
Esteve Reyner, Jordi|||0000-0002-8056-648X
Urbano Ispizua, Álvaro|||0000-0002-7529-9399
Carreras, E.
Fernandez Aviles, Francesc|||0000-0003-3051-3926
Rovira, Montserrat
Martínez, Carmen|||0000-0002-8401-7306
author_role author
author2 Pedraza, Alexandra|||0000-0002-6039-8140
Charry, Paola|||0000-0002-4777-9643
Suárez-Lledó Grande, María|||0009-0004-4573-0581
Rodríguez Lobato, Luis Gerardo|||0000-0001-5694-0921
Brusosa, M.|||0009-0000-5336-3751
Solano, María Teresa
Serrahima, Anna|||0000-0002-7487-5358
Nomdedeu, Meritxell
Cid, Joan|||0000-0001-5445-4508
Lozano, Miquel|||0000-0003-2593-833X
Arcarons, Jordi|||0000-0002-1356-6260
de Llobet, Noemí|||0009-0004-3515-5632
Rosiñol, Laura|||0000-0002-2534-9239
Esteve Reyner, Jordi|||0000-0002-8056-648X
Urbano Ispizua, Álvaro|||0000-0002-7529-9399
Carreras, E.
Fernandez Aviles, Francesc|||0000-0003-3051-3926
Rovira, Montserrat
Martínez, Carmen|||0000-0002-8401-7306
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Allogeneic stem cell transplantation
Matched related donor
Matched unrelated donor
PTCy/Tac
Peripheral blood stem cell grafts
Post-transplantation cyclophosphamide
Tacrolimus
topic Allogeneic stem cell transplantation
Matched related donor
Matched unrelated donor
PTCy/Tac
Peripheral blood stem cell grafts
Post-transplantation cyclophosphamide
Tacrolimus
description This study compared the efficacy of graft-versus-host disease (GVHD) prophylaxis with post-transplantation cyclophosphamide (PTCy) and tacrolimus (Tac) versus other regimens in 272 adults undergoing peripheral blood (PB) allogeneic hematopoietic cell transplantation (allo-HCT) from HLA-matched donors. Of these 272 patients, 95 (34.9%) received PTCy/Tac. The times to neutrophil and platelet engraftment were longer in the PTCy/Tac group (20 days versus 16 days for neutrophils and 19 days versus 12 days for platelets). The day +30 cumulative incidence (CuI) of bacterial bloodstream infection was higher in the PTCy/Tac group (43.2% versus 13.0%; P <.001). The CuIs of grade II-IV and grade III-IV acute GVHD (aGVHD) at day +180 were 14.7% and 4.2%, and the CuI of moderate/severe cGVHD at 2 years was 2.4% in the PTCy/Tac group and 41.8% (hazard ratio [HR],.29; P <.001), 15.8%, (HR,.24; P =.007), and 47.0% (HR,.05; P <.001), respectively, in the no-PTCy group. The duration of immunosuppression was shorter in patients receiving PTCy/Tac (6.2 months versus 9.0 months; P <.001). PTCy/Tac patients had higher OS (2 years: 74.3% versus 60.9%; HR,.54; P =.012), lower NRM (2 years: 8.6% versus 15.8%; HR,.54; P =.11), comparable CuI of relapse (2 years: 26.0% versus 24.4%; HR, 1.03; P =.89), and higher GRFS (2 years: 59.1% versus 16.7%; HR,.32; P <.001). Using PTCy/Tac in HLA-matched PB allo-HCT improved transplantation outcomes at out institution compared with previous prophylactic regimens, including a higher probability of survival despite more delayed engraftment and a higher rate of bacterial infection.
publishDate 2024
dc.date.none.fl_str_mv 2
2024-01-01
2024
2024-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/311606
https://dx.doi.org/urn:doi:10.1016/j.jtct.2023.11.020
url https://ddd.uab.cat/record/311606
https://dx.doi.org/urn:doi:10.1016/j.jtct.2023.11.020
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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