RT Journal Article
T1 Post-Transplantation Cyclophosphamide for Graft-versus- Host Disease Prophylaxis in Multiple Myeloma Patients Who Underwent Allogeneic Hematopoietic Cell Transplantation: First Comparison by Donor Type. A Study from the Chronic Malignancies Working Party of the European Society for Blood and Marrow Transplantation
A1 Sahebi, Firoozeh
A1 Eikema, Dirk-Jan
A1 Koster, Linda
A1 Kroger, Nicolaus
A1 Meijer, Ellen
A1 van Doesum, Jaap A.
A1 Rovira, Montserrat
A1 Koc, Yener
A1 Angelucci, Emanuele
A1 Blaise, Didier
A1 Sammassimo, Simona
A1 McDonald, Andrew
A1 Arroyo, Concepcion Herrera
A1 Sanchez, James F.
A1 Forcade, Edouard
A1 Castagna, Luca
A1 Stolzel, Friedrich
A1 Sanz, Jaime
A1 Tischer, Johanna
A1 Ciceri, Fabio
A1 Valcarcel, David
A1 Proia, Anna
A1 Hayden, Patrick J.
A1 Beksac, Meral
A1 Yakoub-Agha, Ibrahim
A1 Schoenland, Stefan
K1 multiple myeloma
K1 transplantation
K1 engraftment
K1 hematology
K1 clinical research
K1 Bone-marrow
K1 Autologous transplantation
K1 Fludarabine
K1 Tolerance
K1 Busulfan
K1 Outcomes
AB Graft-versus-host disease (GVHD) remains among the major causes of treatment failure in patients with multiple myeloma (MM) undergoing allogeneic hematopoietic cell transplantation (allo-HCT). The use of post-transplantation cyclophosphamide (PT-Cy) is now a well-established and widely used method for GVHD prophylaxis after HLA haploidentical HCT. However, the rationale for using PT-Cy in the setting of matched donor transplantation is less apparent, given the lesser degree of bidirectional alloreactivity. In this retrospective study, we investigated the role of PT-Cy as GVHD prophylaxis in patients with multiple myeloma underoing allo-HCT, among different donor types, to determine cumulative incidence of acute and chronic GVHD and impact on engraftment, progression-free survival (PFS), GVHD-free/relapse- free survival (GRFS), overall survival (OS), and NRM A total of 295 patients with MM underwent allo-HCT using grafts from a matched related donor (MRD; n = 67), matched unrelated donor (MUD; n = 72), mismatched related or unrelated donor (MMRD/MMUD, 1 antigen; n = 27), or haploidentical donor (haplo; n = 129) using PT-Cy between 2012 and 2018. In addition to PT-Cy, agents used in GVHD prophylaxis included calcineurin inhibitors in 239 patients (81%), with mycophenolate mofetil in 184 of those 239 (77%). For grade II-IV acute GVHD, the cumulative incidence at day +100 was 30% (95% confidence interval [CI], 25% to 36%), 9% (95% CI, 5% to 12%) for grade III-IV acute GVHD, and 27% (95% CI, 21% to 32%) for chronic GVHD (limited, 21%; extensive, 6%), with no differences by donor type. The median time to neutrophil engraftment was 19d (95% CI, 18-19), with no significant difference by donor type. The median time to platelet engraftment was delayed in haploidentical donor graft recipients (27 days versus 21 days; P
PB Elsevier science inc
SN 2666-6375
YR 2021
FD 2021-12-08
LK https://hdl.handle.net/10668/25370
UL https://hdl.handle.net/10668/25370
LA en
DS RISalud
RD Apr 10, 2025