Sistema de Salut de Catalunya
Institut Català de la Salut
[Montoro J] Department of Hematology, Hospital Universitario y Politécnico La Fe, Valencia, Spain. Department of Hematology, Universidad Católica de Valencia, Valencia, Spain. [Ngoya M] Department of Biostatistics, EBMT Lymphoma Working Party, Paris, France. [Kulagin A] RM Gorbacheva Research Institute, Pavlov University, Saint-Petersburg, Russia. [Giebel S] Department of Bone Marrow Transplantation and Oncohematology, Fundacja Na Ratunek Dzieciom z Chorobą Nowotworową, Gliwice, Poland. [Broers AEC] Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands. [Bramanti S] IRCCS Humanitas Research Hospital, Transplantation Unit Department of Oncology and Haematology, Milan, Italy. [Fox L] Servei d’Hematologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain
Vall d'Hebron Barcelona Hospital Campus
2024-08-22T10:14:20Z
2024-08-22T10:14:20Z
2024-08-13
Profilaxi; Trasplantaments; Limfoma de Hodgkin
Profilaxis; Trasplantes; Linfoma de Hodgkin
Orophylaxis; Transplants; Hodgkin lymphoma
Studies comparing the efficacy of posttransplant cyclophosphamide (PTCy) to conventional calcineurin inhibitor (CNI)–based graft-versus-host disease (GVHD) prophylaxis regimens in patients with Hodgkin lymphoma (HL) are scarce. This study aimed to compare the outcomes of patients with HL undergoing hematopoietic stem cell transplantation (HSCT) from HLA-matched donors who received GVHD prophylaxis with either PTCy- or conventional CNI-based regimens, using data reported in the European Society for Blood and Marrow Transplantation database between January 2015 and December 2022. Among the cohort, 270 recipients received conventional CNI-based prophylaxis and 176 received PTCy prophylaxis. Notably, PTCy prophylaxis was associated with delayed hematopoietic recovery but also with a lower risk of chronic (25% vs 43%; P < .001) and extensive chronic GVHD (13% vs 28%; P = .003) compared with the CNI-based cohort. The 2-year cumulative incidence of nonrelapse mortality and relapse was 11% vs 17% (P = .12) and 17% vs 30% (P = .007) for PTCy- and CNI-based, respectively. Moreover, the 2-year overall survival (OS), progression-free survival (PFS), and GVHD-free, relapse-free survival (GRFS) were all significantly better in the PTCy group compared with the CNI-based group: 85% vs 72% (P = .005), 72% vs 53% (P < .001), and 59% vs 31% (P < .001), respectively. In multivariable analysis, PTCy was associated with a lower risk of chronic and extensive chronic GVHD, reduced relapse, and better OS, PFS, and GRFS than the CNI-based platform. Our findings suggest that PTCy as GVHD prophylaxis offers more favorable outcomes than conventional CNI-based prophylaxis in adult patients with HL undergoing HSCT from HLA-matched donors.
Article
Published version
English
Inhibidors enzimàtics - Ús terapèutic; Empelt contra l'hoste, Malaltia de l'; Cèl·lules mare hematopoètiques - Trasplantació; Hodgkin, Malaltia de - Tractament; DISEASES::Hemic and Lymphatic Diseases::Lymphatic Diseases::Lymphoproliferative Disorders::Lymphoma::Hodgkin Disease; Other subheadings::Other subheadings::/therapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Biological Therapy::Cell- and Tissue-Based Therapy::Cell Transplantation::Stem Cell Transplantation::Hematopoietic Stem Cell Transplantation; DISEASES::Immune System Diseases::Graft vs Host Disease; CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Enzyme Inhibitors::Calcineurin Inhibitors; ENFERMEDADES::enfermedades hematológicas y linfáticas::enfermedades linfáticas::trastornos linfoproliferativos::linfoma::enfermedad de Hodgkin; Otros calificadores::Otros calificadores::/terapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapia biológica::tratamientos basados en células y tejidos::trasplante de células::trasplante de células madre::trasplante de células madre hematopoyéticas; ENFERMEDADES::enfermedades del sistema inmune::enfermedad injerto contra huésped; COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::mecanismos moleculares de acción farmacológica::inhibidores enzimáticos::inhibidores de calcineurina
American Society of Hematology
Blood Advances;8(15)
https://doi.org/10.1182/bloodadvances.2024013328
Attribution-NonCommercial-NoDerivatives 4.0 International
http://creativecommons.org/licenses/by-nc-nd/4.0/
Articles científics - HVH [3439]
