Evidence map›Paper›PMID 38809457›Full record

ArticleAnnals of hematology2024

Reduced-toxicity conditioning regimen with low dose post-transplantation cyclophosphamide and low-dose anti-thymocyte globulin as graft-versus-host disease prophylaxis for haploidentical stem cell transplantation in older patients.

Peipei Ye, Mengjie Wu, Junjie Cao, Renzhi Pei, Jiaojiao Yuan, Haihui Zhuang, Ying Fang, Ying Lu

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Article in Annals of hematology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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3 · Its place in the literature

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1 citing paper in PubMed.

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5 · Who and what money

Authors and funding

8 authors.

Peipei YeDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Mengjie WuDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Junjie CaoDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Renzhi PeiDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Jiaojiao YuanDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Haihui ZhuangDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Ying FangDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China.
Ying LuDepartment of Hematology, The Affiliated People's Hospital of Ningbo University, Ningbo, Zhejiang, China. rmluying@nbu.edu.cn.

Funding

Ningbo Clinical Research Center for Ophthalmology 2022L003Ningbo Public Welfare Science and Technology Planning Project 2022S020the Zhejiang Provincial Medical and Health Science and Technology Project 2022KY1184
6 · The paper itself

Abstract

Reduced-toxicity conditioning (RIC) regimens are used for allogeneic hematopoietic stem cell transplantation in older patients. However, successful outcomes are hindered by graft-versus-host disease (GVHD), treatment-related mortality, and relapse, particularly after haploidentical donor hematopoietic stem cell transplantation (HID-HSCT). The aim of this study was to evaluate the effectiveness of an RIC conditioning regimen that included a combination of cyclosporin A, methotrexate (on day + 1), mycophenolate, lower doses of post-transplantation PTCy (40 mg/kg on day + 3), and ATG (7.5 mg/kg) as GVHD prophylaxis prior to haplo-stem cell transplantation (haplo-SCT) in older patients.

methodsWe retrospectively analyzed outcomes in 55 patients ≥ 55 years of age with hematologic malignancies treated with fludarabine, cytarabine, busulfan, and low-dose cyclophosphamide as the conditioning regimen between January 1, 2019, and November 30, 2023.

resultsNeutrophil engraftment was successful in all patients within 28 days, with 54 patients (98.2%) achieving complete donor chimerism. The cumulative incidence of non-relapse mortality was 0% at 30 days, 7.5% at 100 days, and 19% at 1 year. The cumulative incidence of grade II-IV acute graft-versus-host disease (aGVHD) was 25% (95%CI, 15-38%), whereas that of grade III-IV aGVHD was 9.1% (95% CI, 3.3-19%). The cumulative incidence of extensive chronic graft-versus-host disease at 1 year was 3.6% (95%CI, 0.66-11%). The cumulative incidences of relapse, overall survival, and GVHD-free/relapse-free survival at 1 year were 9.0%, 71.6%, and 67.1%, respectively.

conclusionsAn RIC conditioning regimen, including a combination of lower PTCy/ATG as GVHD prophylaxis, followed by haplo-SCT, might be a promising option for appropriately selected older patients.

Indexed as

Antilymphocyte SerumCyclophosphamideGraft vs Host DiseaseHematopoietic Stem Cell TransplantationTransplantation ConditioningAgedFemaleHematologic NeoplasmsHumansMaleMiddle AgedRetrospective StudiesTransplantation, HaploidenticalAntilymphocyte SerumCyclophosphamideAnti-thymocyte globulinHaploidentical stem cell transplantationOlder patientsPost-transplantation cyclophosphamideReduced-toxicity conditioning regimen

Identifiers

PMID38809457

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