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PTCy versus ATG as graft-versus-host disease prophylaxis in mismatched unrelated stem cell transplantation

Authors :
Olaf Penack
Mouad Abouqateb
Christophe Peczynski
William Boreland
Zafer Gülbas
Tobias Gedde-Dahl
Cristina Castilla-Llorente
Nicolaus Kröger
Mathias Eder
Alessandro Rambaldi
Francesca Bonifazi
Igor Wolfgang Blau
Matthias Stelljes
Peter Dreger
Ivan Moiseev
Hélène Schoemans
Christian Koenecke
Zinaida Peric
Source :
Blood Cancer Journal, Vol 14, Iss 1, Pp 1-8 (2024)
Publication Year :
2024
Publisher :
Nature Publishing Group, 2024.

Abstract

Abstract There is an increased risk of GVHD and of non-relapse mortality (NRM) after allogeneic stem cell transplantations (alloSCT) when mismatched unrelated donors (MMUD) are used. In Europe, it is standard practice to use rabbit anti-thymocyte globulin (rATG) to reduce the high NRM and GVHD risks after MMUD alloSCT. As an alternative to rATG, post-transplantation Cyclophosphamide (PTCy) is in increasing clinical use. It is currently impossible to give general recommendations regarding preference for one method over another since comparative evidence from larger data sets is lacking. To improve the evidence base, we analyzed the outcome of rATG vs. PTCy prophylaxis in adult patients with hematologic malignancies undergoing first peripheral blood alloSCT from MMUD (9/10 antigen match) between Jan 2018 and June 2021 in the database of the European Society for Blood and Marrow Transplantation (EBMT). We performed multivariate analyses using the Cox proportional-hazards regression model. We included 2123 patients in the final analyses (PTCy, n = 583; rATG, n = 1540). p values and hazard ratios (HR) presented here are multivariate outcomes. Two years after alloSCT we found a lower NRM in the PTCy group of 18% vs. 24.9% in the rATG group; p = 0.028, HR 0.74. Overall survival in the PTCy cohort was higher with 65.7% vs. 55.7% in the rATG cohort; p

Details

Language :
English
ISSN :
20445385
Volume :
14
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Blood Cancer Journal
Publication Type :
Academic Journal
Accession number :
edsdoj.088862a804d845c78b5a8f61b6c2b139
Document Type :
article
Full Text :
https://doi.org/10.1038/s41408-024-01032-8