TY - JOUR
T1 - Impact of post-transplant cyclophosphamide (PTCy)-based prophylaxis in matched sibling donor allogeneic haematopoietic cell transplantation for patients with myelodysplastic syndrome
T2 - a retrospective study on behalf of the Chronic Malignancies Working Party of the EBMT
AU - Salas, María Queralt
AU - Eikema, Diderik Jan
AU - Koster, Linda
AU - Maertens, Johan
AU - Passweg, Jakob
AU - Finke, Jürgen
AU - Broers, Annoek E.C.
AU - Koc, Yener
AU - Kröger, Nicolaus
AU - Ozkurt, Zubeyde Nur
AU - Pascual-Cascon, María Jesús
AU - Platzbecker, Uwe
AU - Van Gorkom, Gwendolyn
AU - Schroeder, Thomas
AU - López-Lorenzo, José Luis
AU - Martino, Massimo
AU - Chiusolo, Patrizia
AU - Kaufmann, Martin
AU - Onida, Francesco
AU - Gurnari, Carmelo
AU - Scheid, Christof
AU - Drozd-Sokolowska, Joanna
AU - Raj, Kavita
AU - Robin, Marie
AU - McLornan, Donal P.
N1 - Publisher Copyright:
© 2024, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2024/4
Y1 - 2024/4
N2 - We retrospectively compared outcomes of 404 MDS patients undergoing 1st matched sibling donor allo-HCT receiving either PTCy-based (n = 66) or other "conventional prophylaxis" (n = 338; mostly calcineurin inhibitor + methotrexate or MMF). Baseline characteristics were balanced, except for higher use of myeloablative regimens in the PTCy group (52.3% vs. 38.2%, p = 0.047). Incidences of neutrophil (Day +28: 89% vs. 97%, p = 0.011) and platelet (Day +100: 89% vs. 97%, p < 0.001) engraftment were lower for PTCy-based. Day +100 cumulative incidences of grade II-IV and III-IV aGVHD, and 5-year CI of extensive cGVHD were 32%, 18% and 18% for PTCy-based and 25% (p = 0.3), 13% (p = 0.4) and 31% (p = 0.09) for the conventional cohort. Five-year OS (51% vs. 52%, p = 0.6) and GRFS (33% vs. 25%, p = 0.6) were similar between groups. Patients receiving PTCy had a trend to a lower cumulative incidence of relapse (20% vs. 33%, p = 0.06), not confirmed on multivariable analysis (p = 0.3). Although higher NRM rates were observed in patients receiving PTCy (32% vs. 21%, p = 0.02) on univariate analysis, this was not confirmed on multivariate analysis (HR 1.46, p = 0.18), and there was no resultant effect on OS (HR 1.20, p = 0.5). Based on these data, PTCy prophylaxis appears to be an attractive option for patients with MDS undergoing MSD allo-HCT.
AB - We retrospectively compared outcomes of 404 MDS patients undergoing 1st matched sibling donor allo-HCT receiving either PTCy-based (n = 66) or other "conventional prophylaxis" (n = 338; mostly calcineurin inhibitor + methotrexate or MMF). Baseline characteristics were balanced, except for higher use of myeloablative regimens in the PTCy group (52.3% vs. 38.2%, p = 0.047). Incidences of neutrophil (Day +28: 89% vs. 97%, p = 0.011) and platelet (Day +100: 89% vs. 97%, p < 0.001) engraftment were lower for PTCy-based. Day +100 cumulative incidences of grade II-IV and III-IV aGVHD, and 5-year CI of extensive cGVHD were 32%, 18% and 18% for PTCy-based and 25% (p = 0.3), 13% (p = 0.4) and 31% (p = 0.09) for the conventional cohort. Five-year OS (51% vs. 52%, p = 0.6) and GRFS (33% vs. 25%, p = 0.6) were similar between groups. Patients receiving PTCy had a trend to a lower cumulative incidence of relapse (20% vs. 33%, p = 0.06), not confirmed on multivariable analysis (p = 0.3). Although higher NRM rates were observed in patients receiving PTCy (32% vs. 21%, p = 0.02) on univariate analysis, this was not confirmed on multivariate analysis (HR 1.46, p = 0.18), and there was no resultant effect on OS (HR 1.20, p = 0.5). Based on these data, PTCy prophylaxis appears to be an attractive option for patients with MDS undergoing MSD allo-HCT.
U2 - 10.1038/s41409-023-02159-1
DO - 10.1038/s41409-023-02159-1
M3 - Article
SN - 0268-3369
VL - 59
SP - 479
EP - 488
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 4
ER -