Dual T-cell depletion with individually tailored anti-thymocyte globulin and attenuated dose of post-transplant cyclophosphamide in haploidentical peripheral stem cell transplantation.
Humans
Antilymphocyte Serum
/ administration & dosage
Cyclophosphamide
/ therapeutic use
Male
Female
Adult
Middle Aged
Graft vs Host Disease
/ prevention & control
Retrospective Studies
T-Lymphocytes
/ immunology
Lymphocyte Depletion
/ methods
Transplantation, Haploidentical
/ methods
Transplantation Conditioning
/ methods
Young Adult
Peripheral Blood Stem Cell Transplantation
/ methods
Adolescent
Myelodysplastic Syndromes
/ therapy
Hematopoietic Stem Cell Transplantation
/ adverse effects
Immunosuppressive Agents
/ administration & dosage
Anti-thymocyte globulin
Graft-versus-host disease
Haploidentical hematopoietic stem cell transplantation
Post-transplant cyclophosphamide
Journal
Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288
Informations de publication
Date de publication:
16 Jun 2024
16 Jun 2024
Historique:
received:
14
03
2024
accepted:
07
06
2024
medline:
17
6
2024
pubmed:
17
6
2024
entrez:
16
6
2024
Statut:
epublish
Résumé
This study aimed to assess the efficacy of dual T-cell suppression using individually tailored doses of antithymocyte globulin (ATG) and attenuated dose of post-transplant cyclophosphamide (PTCy) in haploidentical hematopoietic stem cell transplantation (haplo-HSCT). We conducted a retrospective analysis of 78 adults with acute leukemia or myelodysplastic syndrome who underwent haplo-HSCT using intravenous busulfan and fludarabine conditioning. Thirty-two patients received attenuated ATG/PTCy, while 46 patients received ATG (7.5 mg/kg) as GVHD prophylaxis. The 100-day cumulative incidence of grade III-IV (9.7% vs. 32.4%, P = 0.018) acute GVHD, as well as 2-year moderate-severe chronic GVHD (13.9% vs. 43.9%, P = 0.018) in the ATG/PTCy group were significantly lower than those in the ATG group. The 2-year overall survival was comparable between the two groups. However, 2-year GVHD-free, relapse-free survival in the ATG/PTCy group was significantly higher compared to that in the ATG group (38.9% vs. 21.7%, P = 0.021). Moreover, during post-engraftment period, the ATG/PTCy group exhibited lower incidences of life-threatening bacterial (12.5% vs. 37%, P = 0.033) and viral infection (0% vs. 17.4%, P = 0.035) than the ATG group. In conclusion, the combination of individually tailored ATG and low-dose PTCy appears to be a promising strategy in haplo-HSCT.
Identifiants
pubmed: 38880835
doi: 10.1038/s41598-024-64361-5
pii: 10.1038/s41598-024-64361-5
doi:
Substances chimiques
Antilymphocyte Serum
0
Cyclophosphamide
8N3DW7272P
Immunosuppressive Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
13885Informations de copyright
© 2024. The Author(s).
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