%0 Journal Article
%A Sahebi, Firoozeh
%A Eikema, Dirk-Jan
%A Koster, Linda
%A Kroger, Nicolaus
%A Meijer, Ellen
%A van Doesum, Jaap A
%A Rovira, Montserrat
%A Koc, Yener
%A Angelucci, Emanuele
%A Blaise, Didier
%A Sammassimo, Simona
%A McDonald, Andrew
%A Arroyo, Concepcion Herrera
%A Sanchez, James F
%A Forcade, Edouard
%A Castagna, Luca
%A Stölzel, Friedrich
%A Sanz, Jaime
%A Tischer, Johanna
%A Ciceri, Fabio
%A Valcarcel, David
%A Proia, Anna
%A Hayden, Patrick J
%A Beksac, Meral
%A Yakoub-Agha, Ibrahim
%A Schönland, Stefan
%T 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.
%D 2021
%U https://hdl.handle.net/10668/25369
%X 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
%K clinical research
%K engraftment
%K hematology
%K multiple myeloma
%K transplantation
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