Back to Search
Start Over
OCTET-CY: a phase II study to investigate the efficacy of post-transplant cyclophosphamide as sole graft-versus-host prophylaxis after allogeneic peripheral blood stem cell transplantation.
- Source :
-
European journal of haematology [Eur J Haematol] 2016 Jan; Vol. 96 (1), pp. 27-35. Date of Electronic Publication: 2015 Mar 16. - Publication Year :
- 2016
-
Abstract
- Objective: Post-transplant cyclophosphamide is increasingly used as graft-versus-host disease (GvHD) prophylaxis in the setting of bone marrow transplantation. No data have been published on the use of single-agent GvHD prophylaxis with post-transplant cyclophosphamide in the setting of peripheral blood stem cell transplantation (PBSCT).<br />Methods: In a phase II trial, 11 patients with myeloma or lymphoma underwent conditioning with fludarabine and busulfan followed by T-replete PBSCT and application of 50 mg/kg/d of cyclophosphamide on day+3 and +4 without other concurrent immunosuppression (IS).<br />Results: Median time to leukocyte, neutrophil, and platelet engraftment was 18, 21, and 18 d. The incidence of grade II-IV and grade III-IV GvHD was 45% and 27%, with a non-relapse mortality (NRM) of 36% at one and 2 yr. After median follow-up of 927 d, overall and relapse-free survival was 64% and 34%. Three patients did not require any further systemic IS until day+100 and thereafter. Analysis of immune reconstitution demonstrated rapid T- and NK-cell recovery. B- and CD3+/CD161+NK/T-cell recovery was superior in patients not receiving additional IS.<br />Conclusion: Post-transplant cyclophosphamide as sole IS in PBSCT is feasible and allows rapid immune recovery. Increased rates of severe acute GvHD explain the observed NRM and may advise a temporary combination partner such as mTor-inhibitors in the PBSCT setting.<br /> (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
- Subjects :
- Adult
Allografts
Cyclophosphamide adverse effects
Female
Graft vs Host Disease blood
Graft vs Host Disease etiology
Hematologic Neoplasms blood
Humans
Male
Middle Aged
Cyclophosphamide administration & dosage
Graft vs Host Disease prevention & control
Hematologic Neoplasms therapy
Peripheral Blood Stem Cell Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0609
- Volume :
- 96
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- European journal of haematology
- Publication Type :
- Academic Journal
- Accession number :
- 25703164
- Full Text :
- https://doi.org/10.1111/ejh.12541