Abstract
This is an update on acute and chronic graft-versus-host disease (GvHD) in 425 patients with hematologic malignancies, undergoing an unmanipulated haploidentical (HAPLO) graft from related donors, with a modified post-transplant cyclophosphamide (PT-CY) regimen. All patients received a myeloablative conditioning regimen, either based on thiotepa busulfan fludarabine (TBF), or on full-dose total body irradiation (TBI). The cumulative incidence of acute GvHD-grade II–IV was 29%, and the CI of GvHD-grade III–IV was 4%. We found older donors and older patients to have higher rates of grade II–IV acute GvHD; female donors, diagnosis, disease phase, year of transplant, and the conditioning regimen had no predictive effect on acute GvHD. There was no impact of grade II GvHD, but a significant impact of grade III–IV acute GvHD, on overall survival. The CI of moderate–severe chronic GvHD was 18%: the major predictor was a previous acute GvHD, followed by combined donor and recipients age. In conclusion, PT-CY given on days+3 + 5 results in a relatively low, but not insignificant risk of acute and chronic GvHD, in patients grafted from the related HAPLO donors. The use of young donors appears to reduce this risk.
| Original language | English |
|---|---|
| Pages (from-to) | 708-712 |
| Number of pages | 5 |
| Journal | Bone Marrow Transplantation |
| Volume | 54 |
| DOIs | |
| Publication status | Published - Aug 1 2019 |
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ASJC Scopus subject areas
- Hematology
- Transplantation
Cite this
Graft versus host disease in unmanipulated haploidentical marrow transplantation with a modified post-transplant cyclophosphamide (PT-CY) regimen : an update on 425 patients. / Bacigalupo, Andrea; Maria Raiola, Anna; Dominietto, Alida; Di Grazia, Carmen; Gualandi, Francesca; Lint, Maria Teresa Van; Chiusolo, Patrizia; Laurenti, Luca; Sora, Federica; Giammarco, Sabrina; Angelucci, Emanuele.
In: Bone Marrow Transplantation, Vol. 54, 01.08.2019, p. 708-712.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Graft versus host disease in unmanipulated haploidentical marrow transplantation with a modified post-transplant cyclophosphamide (PT-CY) regimen
T2 - an update on 425 patients
AU - Bacigalupo, Andrea
AU - Maria Raiola, Anna
AU - Dominietto, Alida
AU - Di Grazia, Carmen
AU - Gualandi, Francesca
AU - Lint, Maria Teresa Van
AU - Chiusolo, Patrizia
AU - Laurenti, Luca
AU - Sora, Federica
AU - Giammarco, Sabrina
AU - Angelucci, Emanuele
PY - 2019/8/1
Y1 - 2019/8/1
N2 - This is an update on acute and chronic graft-versus-host disease (GvHD) in 425 patients with hematologic malignancies, undergoing an unmanipulated haploidentical (HAPLO) graft from related donors, with a modified post-transplant cyclophosphamide (PT-CY) regimen. All patients received a myeloablative conditioning regimen, either based on thiotepa busulfan fludarabine (TBF), or on full-dose total body irradiation (TBI). The cumulative incidence of acute GvHD-grade II–IV was 29%, and the CI of GvHD-grade III–IV was 4%. We found older donors and older patients to have higher rates of grade II–IV acute GvHD; female donors, diagnosis, disease phase, year of transplant, and the conditioning regimen had no predictive effect on acute GvHD. There was no impact of grade II GvHD, but a significant impact of grade III–IV acute GvHD, on overall survival. The CI of moderate–severe chronic GvHD was 18%: the major predictor was a previous acute GvHD, followed by combined donor and recipients age. In conclusion, PT-CY given on days+3 + 5 results in a relatively low, but not insignificant risk of acute and chronic GvHD, in patients grafted from the related HAPLO donors. The use of young donors appears to reduce this risk.
AB - This is an update on acute and chronic graft-versus-host disease (GvHD) in 425 patients with hematologic malignancies, undergoing an unmanipulated haploidentical (HAPLO) graft from related donors, with a modified post-transplant cyclophosphamide (PT-CY) regimen. All patients received a myeloablative conditioning regimen, either based on thiotepa busulfan fludarabine (TBF), or on full-dose total body irradiation (TBI). The cumulative incidence of acute GvHD-grade II–IV was 29%, and the CI of GvHD-grade III–IV was 4%. We found older donors and older patients to have higher rates of grade II–IV acute GvHD; female donors, diagnosis, disease phase, year of transplant, and the conditioning regimen had no predictive effect on acute GvHD. There was no impact of grade II GvHD, but a significant impact of grade III–IV acute GvHD, on overall survival. The CI of moderate–severe chronic GvHD was 18%: the major predictor was a previous acute GvHD, followed by combined donor and recipients age. In conclusion, PT-CY given on days+3 + 5 results in a relatively low, but not insignificant risk of acute and chronic GvHD, in patients grafted from the related HAPLO donors. The use of young donors appears to reduce this risk.
UR - http://www.scopus.com/inward/record.url?scp=85070822601&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85070822601&partnerID=8YFLogxK
U2 - 10.1038/s41409-019-0594-1
DO - 10.1038/s41409-019-0594-1
M3 - Article
AN - SCOPUS:85070822601
VL - 54
SP - 708
EP - 712
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
SN - 0268-3369
ER -