Tacrolimus versus cyclosporine a combined with post-transplantation cyclophosphamide for AML In first complete remission: a study from the acute leukemia working party (EBMT).


Journal

Bone marrow transplantation
ISSN: 1476-5365
Titre abrégé: Bone Marrow Transplant
Pays: England
ID NLM: 8702459

Informations de publication

Date de publication:
03 Jul 2024
Historique:
received: 18 02 2024
accepted: 11 06 2024
revised: 09 06 2024
medline: 4 7 2024
pubmed: 4 7 2024
entrez: 3 7 2024
Statut: aheadofprint

Résumé

Choice of calcineurin inhibitor may impact the outcome of patients undergoing T-cell replete hematopoietic cell transplantation (HCT) with post-transplant cyclophosphamide (PT-Cy) and mycophenolate mofetil (MMF) for prophylaxis of graft-versus-host disease (GVHD). We retrospectively analyzed 2427 patients with acute myeloid leukemia (AML) in first remission transplanted from a haploidentical (n = 1844) or unrelated donor (UD, n = 583) using cyclosporine A (CSA, 63%) or tacrolimus (TAC, 37%) and PT-Cy/MMF. In univariate analysis, CSA and TAC groups did not differ in 2-year leukemia-free or overall survival, cumulative incidence (CI) of relapse or non-relapse mortality. CI of severe grade III-IV acute GVHD was lower with TAC (6.6% vs. 9.1%, p = 0.02), without difference in grade II-IV acute GVHD or grade III-IV acute GVHD/severe chronic GVHD, relapse-free survival (GRFS). In multivariate analysis, TAC was associated with a lower risk of severe grade III-IV acute GVHD solely with haploidentical donors (HR 0.64 [95% CI, 0.42-0.98], p = 0.04), but not UD (HR 0.49 [95% CI, 0.2-1.21], p = 0.12). There was no significant difference for chronic GVHD. In conclusion, PT-Cy/MMF-based GVHD prophylaxis resulted in favorable OS and GRFS, irrespective of the CNI added. In haploidentical HCT, TAC seemed to prevent severe acute GVHD more effectively than CSA without impact on other outcome parameters.

Identifiants

pubmed: 38961258
doi: 10.1038/s41409-024-02331-1
pii: 10.1038/s41409-024-02331-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

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Auteurs

Gesine Bug (G)

Goethe University Frankfurt, University Hospital, Dept of Medicine 2, Frankfurt am Main, Germany. g.bug@em.uni-frankfurt.de.

Myriam Labopin (M)

Sorbonne University, Department of Hematology, Saint Antoine Hospital, INSERM UMR 938, Paris, France.

Alexander Kulagin (A)

RM Gorbacheva Research Institute, Pavlov University, St. Petersburg, Russian Federation.

Didier Blaise (D)

Transplant and cellular immunotherapy program, Department of hematology, Institut Paoli Calmettes, Management Sport Cancer lab, Luminy, Aix Marseille University, Marseille, France.

Anna Maria Raiola (AM)

IRCCS San Martino Hospital, Genova, Italy.

Jan Vydra (J)

Institute of Hematology and Blood Transfusion, Prague, Czech Republic.

Simona Sica (S)

Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica Sacro Cuore, Rome, Italy.

Mi Kwon (M)

Department of Hematology, Hospital General Universitario Gregorio Marañon, Instituto de Investigación Sanitaria Gregorio Marañón, Univesidad Complutense de Madrid, Madrid, Spain.

Lucía López-Corral (L)

Hospital Universitario de Salamanca (Spain), IBSAL, Centro de Investigación del Cáncer-IBMCC (USAL-CSIC), Salamanca, Spain.

Stefania Bramanti (S)

Department of Oncology/Hematology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089 Rozzano, Milan, Italy.

Peter von dem Borne (P)

Leiden University Medical Center, Leiden, Netherlands.

Maija Itälä-Remes (M)

Turku University Hospital, Turku, Finland.

Massimo Martino (M)

Stem Cell Transplantation and Cellular Therapies Unit (CTMO), Grande Ospedale Metropolitano "Bianchi-Melacrino-Morelli", Reggio Calabria, Italy.

Yener Koc (Y)

Medicana International Hospital, Istanbul, Turkey.

Eolia Brissot (E)

Sorbonne University, Department of Hematology, Saint Antoine Hospital, INSERM UMR 938, Paris, France.

Sebastian Giebel (S)

Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland.

Arnon Nagler (A)

Chaim Sheba Medical Center, Tel Hashomer, Israel.

Fabio Ciceri (F)

IRCCS San Raffaele Scientific Institute, Milan, Italy.

Mohamad Mohty (M)

Sorbonne University, Department of Hematology, Saint Antoine Hospital, INSERM UMR 938, Paris, France.

Classifications MeSH