GvHD prophylaxis with tacrolimus, sirolimus, and mycophenolate mofetil after reduced intensity conditioning hematopoietic stem cell allogeneic transplantation

[EN]We present the largest prospective real-world experience in 159 patients who received the triple combination of tacrolimus/ sirolimus/mycophenolate mofetil after reduced intensity conditioning allogeneic hematopoietic stem cell transplantation (RICalloHSCT) from matched-related (MRD), matched-un...

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Detalles Bibliográficos
Autores: López Corral, Lucía, Blázquez-Goñi, C., Pérez-López, E., Martín-Domínguez, FM, Cabero Martínez, A., Rodríguez-Torres, N., Cabrero, M., Espigado-Tocino, I., Martín López, AA, Parody-Porras, R., Baile-González, Mónica, Caballero-Velázquez, T., Cortés Rodríguez, María, Soria-Saldise, E., Avendaño Pita, A., Alcalde-Mellado, P., García Bacelar, A., Rodríguez-Arbolí, E., López Parra, Miriam, Falantes-González, JF, Navarro Bailón, Almudena, Vázquez López, Lourdes, Escamilla-Gómez, V., Sánchez Guijo Martín, Fermín, Pérez-Simón, JA
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Universidad de Salamanca (USAL)
Repositorio:GREDOS. Repositorio Institucional de la Universidad de Salamanca
OAI Identifier:oai:gredos.usal.es:10366/169520
Acceso en línea:http://hdl.handle.net/10366/169520
Access Level:acceso abierto
Palabra clave:Bone marrow transplantation
Gvhd prophylaxis
Haematological cancer
Haematopoietic stem cells
Descripción
Sumario:[EN]We present the largest prospective real-world experience in 159 patients who received the triple combination of tacrolimus/ sirolimus/mycophenolate mofetil after reduced intensity conditioning allogeneic hematopoietic stem cell transplantation (RICalloHSCT) from matched-related (MRD), matched-unrelated (MUD) or mismatched-unrelated donors (MMURD). Despite the highrisk and elderly population, non-relapse mortality (NRM) at day +100 and 1 year was 5.1% and 8.6%. Grades 2-4 and 3-4 acute Graftversus-host disease (GvHD) at day +180 was 30.3% and 13%, respectively. Chronic GvHD at 1 and 3 years was 23.2% and 41% and for moderate/severe was 13.2% and 26.6%, respectively. With a median follow-up of 20 months, the 1- and 3-year progression-free survival was 60% and 49%, the GvHD-free relapse-free survival was 44% and 32%, and the overall survival was 70.3% and 61%, respectively, for the entire cohort. Patients receiving allo-HSCT from MMURD showed a higher incidence of aGvHD with impact on survival endpoints. GvHD prophylaxis with the triple-drug combination tacrolimus/sirolimus/mycophenolate mofetil showed excellent results in terms of NRM, GvHD and survival in a high-risk, frail and elderly population in the context of RIC-HSCT from MRD and MUD. The subgroup of patients receiving RIC-HSCT from MMURD might probably benefit from other prophylaxis strategies.

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