Low-dose antithymocyte globulin plus low-dose posttransplant cyclophosphamide combined with cyclosporine and mycophenolate mofetil for prevention of graft-versus-host disease after HLA-matched unrelated donor peripheral blood stem cell transplantation.
Antilymphocyte Serum
/ therapeutic use
Cyclophosphamide
Cyclosporine
/ therapeutic use
Graft vs Host Disease
/ prevention & control
Hematopoietic Stem Cell Transplantation
Humans
Mycophenolic Acid
Neoplasm Recurrence, Local
Peripheral Blood Stem Cell Transplantation
Transplantation Conditioning
Unrelated Donors
Journal
Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459
Informations de publication
Date de publication:
10 2021
10 2021
Historique:
received:
07
02
2021
accepted:
14
05
2021
revised:
04
05
2021
pubmed:
27
5
2021
medline:
14
10
2021
entrez:
26
5
2021
Statut:
ppublish
Résumé
The standard regimens for graft-versus-host disease (GvHD) prophylaxis in matched unrelated donor (MUD) transplantation were based on antithymocyte globulin (ATG) in combination with calcineurin inhibitors (CNIs). To improve the efficiency of GvHD prophylaxis in MUD peripheral blood stem cell transplantation (MUD-PBSCT), 51 patients with hematological malignancies received a novel regimen for GvHD prophylaxis, which is composed of low dose of ATG (5 mg/kg) plus low-dose posttransplant cyclophosphamide (PTCy, 50 mg/kg) (low-dose ATG/PTCy) combined with cyclosporine A (CsA) and mycophenolate mofetil (MMF). The cumulative incidences (CIs) of grades I-IV and II-IV acute GvHD (aGvHD) were 14.5% (95% CI, 9.4-19.6%) and 6.2% (95% CI, 2.8-9.6%) within 100 days after transplantation, respectively. The CI of mild-to-moderate chronic GvHD (cGvHD) within 1 year was 11.5% (95% CI, 6.6-16.4%). The 1-year probabilities of GvHD and relapse-free survival, relapse-free survival, and over survival were 70.6% (95% CI, 64.2-77.0%), 76.5% (95% CI, 70.6-82.4%), and 82.0% (95% CI, 76.5-87.5%), respectively. The CIs of CMV and EBV reactivation by day 180 were 10.4% (95% CI, 1.5-19.4%) and 8.3% (95% CI, 0.2-16.4%), respectively. The results suggested that low-dose ATG/PTCy combined with CsA/MMF as GvHD prophylaxis in MUD-PBSCT had promising activity.
Identifiants
pubmed: 34035462
doi: 10.1038/s41409-021-01358-y
pii: 10.1038/s41409-021-01358-y
pmc: PMC8486671
doi:
Substances chimiques
Antilymphocyte Serum
0
Cyclosporine
83HN0GTJ6D
Cyclophosphamide
8N3DW7272P
Mycophenolic Acid
HU9DX48N0T
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
2423-2431Informations de copyright
© 2021. The Author(s).
Références
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