TY - JOUR
T1 - Reduced dose of posttransplant cyclophosphamide in HLA-haploidentical peripheral blood stem cell transplantation
AU - Sugita, Junichi
AU - Kamimura, Tomohiko
AU - Ishikawa, Takayuki
AU - Ota, Shuichi
AU - Eto, Tetsuya
AU - Kuroha, Takashi
AU - Miyazaki, Yasuhiko
AU - Kumagai, Hiroaki
AU - Matsuo, Keitaro
AU - Akashi, Koichi
AU - Taniguchi, Shuichi
AU - Harada, Mine
AU - Teshima, Takanori
N1 - Funding Information:
Acknowledgements This work was supported by the grant from Regional Medicine Research Foundation (Tochigi, Japan), North Japan Hematology Study Group (NJHSG), and Japan Agency for Medical Research and Development (AMED, 19ek0510025h0002).
Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2021/3
Y1 - 2021/3
N2 - Posttransplant cyclophosphamide (PTCy:100 mg/kg) has been increasingly used in allogeneic hematopoietic stem cell transplantation, however, few studies compared different doses of PTCy. We conducted two consecutive prospective multicenter phase II studies to evaluate the safety and efficacy of 80 mg/kg of PTCy in 137 patients who underwent HLA-haploidentical peripheral blood stem cell transplantation (haploPBSCT) following reduced-intensity conditioning (RIC). GVHD prophylaxis consisted of PTCy at a dose of 40 mg/kg/day on days 3 and 4, tacrolimus, and mycophenolate mofetil. Neutrophil engraftment was achieved in 97% and 96% in the first and second studies, respectively. The incidences of grades II–IV acute GVHD, III–IV acute GVHD, all grade chronic GVHD, and moderate to severe chronic GVHD at 2 years were 26%, 5%, 35%, and 18% in the first study, and 23%, 1%, 28%, and 15% in the second study, respectively. Overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) at 2 years were 51%, 42%, and 18% in the first study, and 58%, 48%, and 16% in the second study, respectively. The rates of off-immunosuppressants in patients who survived without relapse at 2 years were 83 and 76%. Our results suggest that 80 mg/kg of PTCy is a valid option in haploPBSCT following RIC.
AB - Posttransplant cyclophosphamide (PTCy:100 mg/kg) has been increasingly used in allogeneic hematopoietic stem cell transplantation, however, few studies compared different doses of PTCy. We conducted two consecutive prospective multicenter phase II studies to evaluate the safety and efficacy of 80 mg/kg of PTCy in 137 patients who underwent HLA-haploidentical peripheral blood stem cell transplantation (haploPBSCT) following reduced-intensity conditioning (RIC). GVHD prophylaxis consisted of PTCy at a dose of 40 mg/kg/day on days 3 and 4, tacrolimus, and mycophenolate mofetil. Neutrophil engraftment was achieved in 97% and 96% in the first and second studies, respectively. The incidences of grades II–IV acute GVHD, III–IV acute GVHD, all grade chronic GVHD, and moderate to severe chronic GVHD at 2 years were 26%, 5%, 35%, and 18% in the first study, and 23%, 1%, 28%, and 15% in the second study, respectively. Overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) at 2 years were 51%, 42%, and 18% in the first study, and 58%, 48%, and 16% in the second study, respectively. The rates of off-immunosuppressants in patients who survived without relapse at 2 years were 83 and 76%. Our results suggest that 80 mg/kg of PTCy is a valid option in haploPBSCT following RIC.
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U2 - 10.1038/s41409-020-01065-0
DO - 10.1038/s41409-020-01065-0
M3 - Article
C2 - 32973350
AN - SCOPUS:85091372202
SN - 0268-3369
VL - 56
SP - 596
EP - 604
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 3
ER -