Risk Factors for Graft-versus-Host Disease in Haploidentical Hematopoietic Cell Transplantation Using Post-Transplant Cyclophosphamide

Annie Im, Armin Rashidi, Tao Wang, Michael Hemmer, Margaret L. MacMillan, Joseph Pidala, Madan Jagasia, Steven Pavletic, Navneet S. Majhail, Daniel Weisdorf, Hisham Abdel-Azim, Vaibhav Agrawal, A. Samer Al-Homsi, Mahmoud Aljurf, Medhat Askar, Jeffery J. Auletta, Asad Bashey, Amer Beitinjaneh, Vijaya Raj Bhatt, Michael ByrneJean-Yves Cahn, Mitchell Cairo, Paul Castillo, Jan Cerny, Saurabh Chhabra, Hannah Choe, Stefan Ciurea, Andrew Daly, Miguel Angel Diaz Perez, Nosha Farhadfar, Shahinaz M. Gadalla, Robert Gale, Siddhartha Ganguly, Usama Gergis, Rabi Hanna, Peiman Hematti, Roger Herzig, Gerhard C. Hildebrandt, Deepesh P. Lad, Catherine Lee, Leslie Lehmann, Lazaros Lekakis, Rammurti T. Kamble, Mohamed A. Kharfan-Dabaja, Pooja Khandelwal, Rodrigo Martino, Hemant S. Murthy, Taiga Nishihori, Tracey A. O'Brien, Richard F. Olsson, Sagar S. Patel, Miguel-Angel Perales, Tim Prestidge, Muna Qayed, Rizwan Romee, Helene Schoemans, Sachiko Seo, Akshay Sharma, Melhem Solh, Roger Strair, Takanori Teshima, Alvaro Urbano-Ispizua, Marjolein Van der Poel, Ravi Vij, John L. Wagner, Basem William, Baldeep Wirk, Jean A. Yared, Steve R. Spellman, Mukta Arora, Betty K. Hamilton*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Post-transplant cyclophosphamide (PTCy) has significantly increased the successful use of haploidentical donors with a relatively low incidence of graft-versus-host disease (GVHD). Given its increasing use, we sought to determine risk factors for GVHD after haploidentical hematopoietic cell transplantation (haplo-HCT) using PTCy. Data from the Center for International Blood and Marrow Transplant Research on adult patients with acute myeloid leukemia, acute lymphoblastic leukemia, myelodysplastic syndrome, or chronic myeloid leukemia who underwent PTCy-based haplo-HCT (2013 to 2016) were analyzed and categorized into 4 groups based on myeloablative (MA) or reduced-intensity conditioning (RIC) and bone marrow (BM) or peripheral blood (PB) graft source. In total, 646 patients were identified (MA-BM = 79, MA-PB = 183, RIC-BM = 192, RIC-PB = 192). The incidence of grade 2 to 4 acute GVHD at 6 months was highest in MA-PB (44%), followed by RIC-PB (36%), MA-BM (36%), and RIC-BM (30%) (P = .002). The incidence of chronic GVHD at 1 year was 40%, 34%, 24%, and 20%, respectively (P <.001). In multivariable analysis, there was no impact of stem cell source or conditioning regimen on grade 2 to 4 acute GVHD; however, older donor age (30 to 49 versus

Original languageEnglish
Pages (from-to)1459-1468
Number of pages10
JournalBiology of Blood and Marrow Transplantation
Volume26
Issue number8
DOIs
Publication statusPublished - Aug 2020

Keywords

  • BLOOD STEM-CELLS
  • BONE-MARROW-TRANSPLANTATION
  • ACUTE MYELOID-LEUKEMIA
  • RELAPSE-FREE SURVIVAL
  • PERIPHERAL-BLOOD
  • HEMATOLOGIC MALIGNANCIES
  • DONOR TRANSPLANTATION
  • CONDITIONING REGIMEN
  • ACUTE GVHD
  • OUTCOMES

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